Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.54 / $40.94 / $140.22	Facility	26	$36.54	$40.94	$140.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.01 / $263.26 / $1,138.35	Professional		$148.01	$263.26	$1,138.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $89.94 / $425.00	Professional	26	$39.00	$89.94	$425.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.46 / $169.58 / $405.97	Professional	TC	$101.46	$169.58	$405.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.94 / $279.74 / $965.78	Professional		$159.94	$279.74	$965.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.11 / $71.50 / $237.39	Professional	26	$39.11	$71.50	$237.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.84 / $212.61 / $728.39	Professional	TC	$120.84	$212.61	$728.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $128.69 / $191.65	Professional		$38.35	$128.69	$191.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.12 / $115.83 / $177.69	Facility	26	$99.12	$115.83	$177.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.87 / $402.38 / $457.25	Professional		$192.87	$402.38	$457.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.16 / $95.14 / $108.11	Professional	26	$46.16	$95.14	$108.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.43 / $307.24 / $349.14	Professional	TC	$136.43	$307.24	$349.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $251.76 / $251.76 / $251.76	Facility	26	$251.76	$251.76	$251.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $206.44 / $364.42 / $1,354.08	Professional		$206.44	$364.42	$1,354.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $99.66 / $335.64	Professional	26	$51.32	$99.66	$335.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $152.10 / $274.83 / $1,018.44	Professional	TC	$152.10	$274.83	$1,018.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $152.28 / $316.99	Professional		$57.01	$152.28	$316.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $267.97 / $373.10 / $537.14	Professional		$267.97	$373.10	$537.14
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $251.76 / $251.76	Facility	26	$100.00	$251.76	$251.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $181.59 / $802.47 / $1,354.08	Professional		$181.59	$802.47	$1,354.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $42.94 / $240.60 / $335.64	Professional	26	$42.94	$240.60	$335.64
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $138.65 / $561.86 / $1,018.44	Professional	TC	$138.65	$561.86	$1,018.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $364.19 / $737.43 / $737.43	Professional		$364.19	$737.43	$737.43
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.90 / $103.35 / $175.88	Professional	26	$99.90	$103.35	$175.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.17 / $302.55 / $463.59	Professional	TC	$257.17	$302.55	$463.59
United Facility/Professional Professional Modifier Low / Median / High Price $190.56 / $338.24 / $598.80	Professional		$190.56	$338.24	$598.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.90 / $85.13 / $150.72	Professional	26	$46.90	$85.13	$150.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.60 / $262.50 / $462.38	Professional	TC	$147.60	$262.50	$462.38