Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.10 / $25.10 / $85.61	Facility	26	$25.10	$25.10	$85.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.93 / $279.60 / $972.00	Professional		$151.93	$279.60	$972.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $28.85 / $97.16	Professional	26	$23.60	$28.85	$97.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.64 / $178.38 / $471.91	Professional	TC	$126.64	$178.38	$471.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $276.04 / $958.28	Professional		$160.00	$276.04	$958.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $42.00 / $144.49	Professional	26	$23.74	$42.00	$144.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.15 / $234.72 / $813.79	Professional	TC	$135.15	$234.72	$813.79
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 $178.07 / $403.52 / $458.55	Professional		$178.07	$403.52	$458.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $57.86 / $65.75	Professional	26	$27.82	$57.86	$65.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.03 / $345.66 / $392.80	Professional	TC	$152.03	$345.66	$392.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $236.27 / $236.27 / $236.27	Facility	26	$236.27	$236.27	$236.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $205.22 / $351.58 / $1,431.47	Professional		$205.22	$351.58	$1,431.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.98 / $50.72 / $293.89	Professional	26	$27.98	$50.72	$293.89
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $175.39 / $303.41 / $1,288.22	Professional	TC	$175.39	$303.41	$1,288.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $156.16 / $316.99	Professional		$57.73	$156.16	$316.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $297.70 / $395.34 / $541.67	Professional		$297.70	$395.34	$541.67
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $236.27 / $236.27	Facility	26	$100.00	$236.27	$236.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.10 / $854.14 / $1,431.47	Professional		$182.10	$854.14	$1,431.47
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $163.26 / $293.89	Professional	26	$26.12	$163.26	$293.89
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $155.97 / $754.12 / $1,288.22	Professional	TC	$155.97	$754.12	$1,288.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $285.45 / $815.01 / $815.01	Professional		$285.45	$815.01	$815.01
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.37 / $72.30 / $177.17	Professional	26	$61.37	$72.30	$177.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $305.48 / $359.39 / $473.73	Professional	TC	$305.48	$359.39	$473.73
United Facility/Professional Professional Modifier Low / Median / High Price $193.08 / $319.56 / $608.36	Professional		$193.08	$319.56	$608.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $44.23 / $89.10	Professional	26	$26.53	$44.23	$89.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.41 / $273.08 / $516.63	Professional	TC	$165.41	$273.08	$516.63