Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.81 / $83.81 / $161.60	Facility	26	$83.81	$83.81	$161.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.65 / $239.65 / $618.86	Professional		$139.65	$239.65	$618.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $65.89 / $189.20	Professional	26	$45.28	$65.89	$189.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.16 / $161.80 / $284.16	Professional	TC	$94.16	$161.80	$284.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.47 / $263.87 / $893.91	Professional		$137.47	$263.87	$893.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.47 / $83.81 / $281.72	Professional	26	$44.47	$83.81	$281.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.56 / $180.06 / $612.19	Professional	TC	$92.56	$180.06	$612.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.54 / $132.68 / $203.54	Facility	26	$113.54	$132.68	$203.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.53 / $394.09 / $447.83	Professional		$203.53	$394.09	$447.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.10 / $124.20 / $141.13	Professional	26	$58.10	$124.20	$141.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.25 / $269.89 / $306.69	Professional	TC	$138.25	$269.89	$306.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $214.35 / $214.35 / $214.35	Facility	26	$214.35	$214.35	$214.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.52 / $319.72 / $1,086.26	Professional		$151.52	$319.72	$1,086.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.13 / $95.62 / $449.09	Professional	26	$51.13	$95.62	$449.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $100.33 / $232.00 / $867.64	Professional	TC	$100.33	$232.00	$867.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $126.96 / $253.98	Professional		$57.01	$126.96	$253.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $252.76 / $385.56 / $654.70	Professional		$252.76	$385.56	$654.70
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $102.88 / $214.35 / $214.35	Facility	26	$102.88	$214.35	$214.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $211.52 / $686.10 / $1,086.26	Professional		$211.52	$686.10	$1,086.26
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.66 / $224.25 / $449.09	Professional	26	$66.66	$224.25	$449.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $144.86 / $465.21 / $867.64	Professional	TC	$144.86	$465.21	$867.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $527.30 / $933.71 / $933.71	Professional		$527.30	$933.71	$933.71
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.65 / $196.86 / $234.99	Professional	26	$186.65	$196.86	$234.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $340.66 / $364.48 / $431.04	Professional	TC	$340.66	$364.48	$431.04
United Facility/Professional Professional Modifier Low / Median / High Price $149.08 / $279.61 / $626.48	Professional		$149.08	$279.61	$626.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.48 / $89.70 / $198.97	Professional	26	$50.48	$89.70	$198.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.81 / $201.48 / $440.70	Professional	TC	$97.81	$201.48	$440.70