Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.00 / $39.00 / $134.18	Facility	26	$39.00	$39.00	$134.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.44 / $300.39 / $948.00	Professional		$259.44	$300.39	$948.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.67 / $41.42 / $136.34	Professional	26	$35.67	$41.42	$136.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.61 / $239.03 / $392.28	Professional	TC	$202.61	$239.03	$392.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.24 / $446.85 / $1,560.89	Professional		$250.24	$446.85	$1,560.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.70 / $64.30 / $225.64	Professional	26	$36.70	$64.30	$225.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.53 / $384.08 / $1,334.92	Professional	TC	$213.53	$384.08	$1,334.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.82 / $108.46 / $166.38	Facility	26	$92.82	$108.46	$166.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.36 / $623.57 / $708.60	Professional		$284.36	$623.57	$708.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.72 / $90.41 / $102.74	Professional	26	$41.72	$90.41	$102.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.26 / $533.16 / $605.86	Professional	TC	$244.26	$533.16	$605.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $171.05 / $171.05 / $171.05	Facility	26	$171.05	$171.05	$171.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $294.42 / $528.62 / $1,627.28	Professional		$294.42	$528.62	$1,627.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.23 / $74.78 / $234.31	Professional	26	$43.23	$74.78	$234.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $254.18 / $440.33 / $1,392.98	Professional	TC	$254.18	$440.33	$1,392.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $215.75 / $446.38	Professional		$58.22	$215.75	$446.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.19 / $582.13 / $838.07	Professional		$377.19	$582.13	$838.07
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $171.05 / $171.05	Facility	26	$85.00	$171.05	$171.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $281.39 / $1,055.25 / $1,627.28	Professional		$281.39	$1,055.25	$1,627.28
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $40.81 / $153.00 / $234.31	Professional	26	$40.81	$153.00	$234.31
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $240.60 / $902.25 / $1,392.98	Professional	TC	$240.60	$902.25	$1,392.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $551.40 / $1,259.46 / $1,259.46	Professional		$551.40	$1,259.46	$1,259.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.20 / $93.17 / $117.89	Professional	26	$79.20	$93.17	$117.89
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $472.21 / $555.54 / $702.92	Professional	TC	$472.21	$555.54	$702.92
United Facility/Professional Professional Modifier Low / Median / High Price $285.33 / $474.97 / $962.44	Professional		$285.33	$474.97	$962.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $72.22 / $139.16	Professional	26	$41.69	$72.22	$139.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.52 / $407.15 / $823.28	Professional	TC	$251.52	$407.15	$823.28