Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $49.08 / $168.10	Facility	26	$49.08	$49.08	$168.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.22 / $291.49 / $574.45	Professional		$219.22	$291.49	$574.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.33 / $53.20 / $222.00	Professional	26	$44.33	$53.20	$222.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.96 / $242.41 / $451.72	Professional	TC	$169.96	$242.41	$451.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.19 / $475.28 / $1,603.03	Professional		$264.19	$475.28	$1,603.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.18 / $80.63 / $283.07	Professional	26	$46.18	$80.63	$283.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $216.44 / $394.63 / $1,319.96	Professional	TC	$216.44	$394.63	$1,319.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.75 / $141.11 / $216.46	Facility	26	$120.75	$141.11	$216.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.08 / $696.19 / $791.13	Professional		$285.08	$696.19	$791.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.90 / $115.89 / $131.69	Professional	26	$51.90	$115.89	$131.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.78 / $580.30 / $659.44	Professional	TC	$234.78	$580.30	$659.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $202.83 / $202.83 / $202.83	Facility	26	$202.83	$202.83	$202.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.30 / $563.00 / $1,904.10	Professional		$316.30	$563.00	$1,904.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $54.32 / $96.58 / $588.72	Professional	26	$54.32	$96.58	$588.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $263.54 / $484.30 / $1,640.58	Professional	TC	$263.54	$484.30	$1,640.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.14 / $249.03 / $506.22	Professional		$58.14	$249.03	$506.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $479.31 / $698.84 / $872.14	Professional		$479.31	$698.84	$872.14
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $108.95 / $202.83 / $202.83	Facility	26	$108.95	$202.83	$202.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $314.17 / $1,317.90 / $1,904.10	Professional		$314.17	$1,317.90	$1,904.10
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $232.75 / $588.72	Professional	26	$52.30	$232.75	$588.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $261.87 / $1,085.15 / $1,640.58	Professional	TC	$261.87	$1,085.15	$1,640.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $472.46 / $1,406.17 / $1,406.17	Professional		$472.46	$1,406.17	$1,406.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.66 / $117.25 / $148.36	Professional	26	$99.66	$117.25	$148.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $476.69 / $560.80 / $992.48	Professional	TC	$476.69	$560.80	$992.48
United Facility/Professional Professional Modifier Low / Median / High Price $307.02 / $545.61 / $988.43	Professional		$307.02	$545.61	$988.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.57 / $84.56 / $174.57	Professional	26	$52.57	$84.56	$174.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.58 / $451.60 / $819.29	Professional	TC	$257.58	$451.60	$819.29