Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.94 / $47.94 / $91.95	Facility	26	$47.94	$47.94	$91.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.32 / $189.37 / $1,139.00	Professional		$106.32	$189.37	$1,139.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $62.45 / $323.02	Professional	26	$23.21	$62.45	$323.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.48 / $104.15 / $234.09	Professional	TC	$74.48	$104.15	$234.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.04 / $189.37 / $689.64	Professional		$96.04	$189.37	$689.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $47.94 / $161.55	Professional	26	$25.42	$47.94	$161.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.48 / $141.43 / $514.67	Professional	TC	$70.48	$141.43	$514.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $78.04 / $118.44	Professional		$25.11	$78.04	$118.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.88 / $75.81 / $116.31	Facility	26	$64.88	$75.81	$116.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.43 / $284.37 / $323.14	Professional		$133.43	$284.37	$323.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $71.23 / $80.94	Professional	26	$33.15	$71.23	$80.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.12 / $213.15 / $242.21	Professional	TC	$102.12	$213.15	$242.21
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $136.00 / $136.00 / $136.00	Facility	26	$136.00	$136.00	$136.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.10 / $219.95 / $698.76	Professional		$111.10	$219.95	$698.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.31 / $55.67 / $279.51	Professional	26	$29.31	$55.67	$279.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $172.60 / $479.00	Professional	TC	$80.70	$172.60	$479.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $93.48 / $196.31	Professional		$38.69	$93.48	$196.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $277.98 / $383.19	Professional		$182.24	$277.98	$383.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $136.00 / $136.00	Facility	26	$100.00	$136.00	$136.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $152.63 / $479.25 / $698.76	Professional		$152.63	$479.25	$698.76
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $38.22 / $127.60 / $279.51	Professional	26	$38.22	$127.60	$279.51
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $114.41 / $351.65 / $479.00	Professional	TC	$114.41	$351.65	$479.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $324.82 / $673.75 / $673.75	Professional		$324.82	$673.75	$673.75
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.27 / $127.96 / $134.46	Professional	26	$106.27	$127.96	$134.46
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.86 / $392.85 / $430.96	Professional	TC	$196.86	$392.85	$430.96
United Facility/Professional Professional Modifier Low / Median / High Price $111.10 / $197.06 / $449.60	Professional		$111.10	$197.06	$449.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.31 / $51.04 / $113.83	Professional	26	$29.31	$51.04	$113.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $148.46 / $335.77	Professional	TC	$80.70	$148.46	$335.77