Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.37 / $155.85 / $239.08	Facility	26	$133.37	$155.85	$239.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $593.92 / $721.11 / $819.44	Professional		$593.92	$721.11	$819.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.62 / $128.10 / $145.56	Professional	26	$101.62	$128.10	$145.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $492.31 / $592.99 / $673.85	Professional	TC	$492.31	$592.99	$673.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $205.41 / $205.41 / $205.41	Facility	26	$205.41	$205.41	$205.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,782.62 / $1,782.62 / $1,782.62	Professional		$1,782.62	$1,782.62	$1,782.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $313.70 / $313.70 / $313.70	Professional	26	$313.70	$313.70	$313.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $1,468.91 / $1,468.91 / $1,468.91	Professional	TC	$1,468.91	$1,468.91	$1,468.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $58.40 / $58.40	Professional		$58.40	$58.40	$58.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $498.35 / $548.19 / $815.18	Professional		$498.35	$548.19	$815.18
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $120.43 / $205.41 / $205.41	Facility	26	$120.43	$205.41	$205.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,220.31 / $1,782.62 / $1,782.62	Professional		$1,220.31	$1,782.62	$1,782.62
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $216.77 / $313.70 / $313.70	Professional	26	$216.77	$313.70	$313.70
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $1,003.50 / $1,468.91 / $1,468.91	Professional	TC	$1,003.50	$1,468.91	$1,468.91