Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.66 / $26.66 / $132.41	Facility	26	$26.66	$26.66	$132.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $140.12 / $283.48	Professional		$101.65	$140.12	$283.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $32.61 / $92.70	Professional	26	$23.74	$32.61	$92.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $113.45 / $206.54	Professional	TC	$69.04	$113.45	$206.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.11 / $282.76 / $952.03	Professional		$153.11	$282.76	$952.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.20 / $46.73 / $154.90	Professional	26	$25.20	$46.73	$154.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.43 / $237.95 / $797.13	Professional	TC	$128.43	$237.95	$797.13
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 $179.18 / $404.88 / $460.09	Professional		$179.18	$404.88	$460.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $62.10 / $85.80	Professional	26	$34.29	$62.10	$85.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.56 / $342.82 / $389.56	Professional	TC	$139.56	$342.82	$389.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $160.47 / $160.47 / $160.47	Facility	26	$160.47	$160.47	$160.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $193.54 / $325.73 / $1,341.64	Professional		$193.54	$325.73	$1,341.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $58.47 / $375.24	Professional	26	$32.86	$58.47	$375.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.25 / $286.24 / $1,090.58	Professional	TC	$158.25	$286.24	$1,090.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $150.21 / $316.99	Professional		$55.31	$150.21	$316.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.44 / $384.36 / $548.49	Professional		$301.44	$384.36	$548.49
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $160.47 / $160.47	Facility	26	$100.00	$160.47	$160.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.72 / $657.70 / $1,341.64	Professional		$182.72	$657.70	$1,341.64
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $127.40 / $375.24	Professional	26	$28.01	$127.40	$375.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $154.69 / $530.29 / $1,090.58	Professional	TC	$154.69	$530.29	$1,090.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $368.26 / $670.65 / $670.65	Professional		$368.26	$670.65	$670.65
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.38 / $63.98 / $93.07	Professional	26	$54.38	$63.98	$93.07
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $258.64 / $304.27 / $565.94	Professional	TC	$258.64	$304.27	$565.94
United Facility/Professional Professional Modifier Low / Median / High Price $187.85 / $318.89 / $587.03	Professional		$187.85	$318.89	$587.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.06 / $52.46 / $95.55	Professional	26	$32.06	$52.46	$95.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.47 / $272.70 / $506.01	Professional	TC	$156.47	$272.70	$506.01