Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.50 / $24.50 / $83.97	Facility	26	$24.50	$24.50	$83.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $146.13 / $450.12	Professional		$119.84	$146.13	$450.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.12 / $24.50 / $145.16	Professional	26	$16.12	$24.50	$145.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.54 / $112.49 / $287.54	Professional	TC	$97.54	$112.49	$287.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.65 / $218.86 / $739.22	Professional		$124.65	$218.86	$739.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.06 / $39.96 / $144.49	Professional	26	$23.06	$39.96	$144.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.83 / $177.92 / $609.65	Professional	TC	$100.83	$177.92	$609.65
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 $138.66 / $312.29 / $362.29	Professional		$138.66	$312.29	$362.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $57.57 / $65.43	Professional	26	$24.49	$57.57	$65.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.58 / $254.72 / $289.45	Professional	TC	$117.58	$254.72	$289.45
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $102.96 / $102.96 / $102.96	Facility	26	$102.96	$102.96	$102.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $265.13 / $1,021.59	Professional		$158.69	$265.13	$1,021.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.56 / $49.07 / $203.09	Professional	26	$21.56	$49.07	$203.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $130.41 / $230.03 / $934.78	Professional	TC	$130.41	$230.03	$934.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $125.92 / $253.98	Professional		$50.00	$125.92	$253.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $228.42 / $289.87 / $415.63	Professional		$228.42	$289.87	$415.63
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $102.96 / $102.96	Facility	26	$100.00	$102.96	$102.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.93 / $620.00 / $1,021.59	Professional		$140.93	$620.00	$1,021.59
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $118.80 / $203.09	Professional	26	$25.99	$118.80	$203.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $114.95 / $501.20 / $934.78	Professional	TC	$114.95	$501.20	$934.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $268.01 / $630.79 / $630.79	Professional		$268.01	$630.79	$630.79
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $60.51 / $76.56	Professional	26	$39.36	$60.51	$76.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.79 / $265.76 / $444.35	Professional	TC	$254.79	$265.76	$444.35
United Facility/Professional Professional Modifier Low / Median / High Price $153.04 / $256.68 / $470.90	Professional		$153.04	$256.68	$470.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $37.96 / $88.02	Professional	26	$20.94	$37.96	$88.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.03 / $201.06 / $382.88	Professional	TC	$122.03	$201.06	$382.88