Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $223.87	Facility	26	$64.57	$64.57	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $371.54	Professional		$107.15	$158.49	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $154.88	Professional	26	$53.70	$66.07	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $64.57 / $173.78	Professional	TC	$52.48	$64.57	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $181.97 / $478.63	Professional		$120.23	$181.97	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $91.20 / $245.47	Professional	26	$60.26	$91.20	$245.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $93.33 / $257.04	Professional	TC	$58.88	$93.33	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $181.97 / $295.12	Facility	26	$158.49	$181.97	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $302.00 / $363.08	Professional		$131.83	$302.00	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $147.91 / $181.97	Professional	26	$66.07	$147.91	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $151.36 / $199.53	Professional	TC	$66.07	$151.36	$199.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $331.13	Professional		$213.80	$245.47	$331.13
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $123.03 / $165.96	Professional	26	$107.15	$123.03	$165.96
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $120.23 / $162.18	Professional	TC	$104.71	$120.23	$162.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	26	$354.81	$354.81	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $257.04 / $1,071.52	Professional		$144.54	$257.04	$1,071.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $109.65 / $371.54	Professional	26	$66.07	$109.65	$371.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $144.54 / $707.95	Professional	TC	$69.18	$144.54	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $181.97	Professional		$32.36	$33.11	$181.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $295.12 / $588.84	Professional		$154.88	$295.12	$588.84
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $371.54 / $371.54	Facility	26	$138.04	$371.54	$371.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $660.69 / $1,096.48	Professional		$131.83	$660.69	$1,096.48
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $309.03 / $371.54	Professional	26	$66.07	$309.03	$371.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $407.38 / $724.44	Professional	TC	$64.57	$407.38	$724.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $354.81 / $602.56	Professional		$257.04	$354.81	$602.56
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $173.78 / $229.09	Professional	26	$147.91	$173.78	$229.09
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $147.91 / $234.42	Professional	TC	$123.03	$147.91	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $208.93 / $407.38	Professional		$125.89	$208.93	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $199.53	Professional	26	$63.10	$91.20	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $114.82 / $223.87	Professional	TC	$61.66	$114.82	$223.87