Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.86 / $24.86 / $84.37	Facility	26	$24.86	$24.86	$84.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.53 / $190.40 / $453.89	Professional		$120.53	$190.40	$453.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.83 / $25.52 / $90.00	Professional	26	$20.83	$25.52	$90.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.18 / $169.58 / $317.57	Professional	TC	$98.18	$169.58	$317.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.56 / $219.41 / $750.01	Professional		$124.56	$219.41	$750.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.39 / $40.90 / $144.52	Professional	26	$23.39	$40.90	$144.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.83 / $178.50 / $605.49	Professional	TC	$100.83	$178.50	$605.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.47 / $69.50 / $106.61	Facility	26	$59.47	$69.50	$106.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.24 / $314.27 / $357.14	Professional		$142.24	$314.27	$357.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.25 / $57.86 / $65.75	Professional	26	$25.25	$57.86	$65.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.78 / $256.42 / $291.39	Professional	TC	$119.78	$256.42	$291.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $174.32 / $174.32 / $174.32	Facility	26	$174.32	$174.32	$174.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.32 / $262.64 / $1,035.17	Professional		$160.32	$262.64	$1,035.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $49.23 / $303.79	Professional	26	$25.98	$49.23	$303.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $129.41 / $224.65 / $922.24	Professional	TC	$129.41	$224.65	$922.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $125.92 / $253.98	Professional		$55.31	$125.92	$253.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.47 / $290.27 / $417.90	Professional		$81.47	$290.27	$417.90
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $174.32 / $174.32	Facility	26	$100.00	$174.32	$174.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.83 / $616.60 / $1,035.17	Professional		$141.83	$616.60	$1,035.17
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $118.85 / $303.79	Professional	26	$26.12	$118.85	$303.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $115.71 / $536.60 / $922.24	Professional	TC	$115.71	$536.60	$922.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $236.23 / $634.78 / $634.78	Professional		$236.23	$634.78	$634.78
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.27 / $61.34 / $92.00	Professional	26	$58.27	$61.34	$92.00
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $215.84 / $253.93 / $464.60	Professional	TC	$215.84	$253.93	$464.60
United Facility/Professional Professional Modifier Low / Median / High Price $155.05 / $255.27 / $470.57	Professional		$155.05	$255.27	$470.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $42.70 / $89.14	Professional	26	$25.98	$42.70	$89.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.87 / $206.53 / $388.10	Professional	TC	$121.87	$206.53	$388.10