Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.86 / $41.80 / $102.26	Facility	26	$29.86	$41.80	$102.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $66.04 / $236.43	Professional		$57.01	$66.04	$236.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.38 / $29.86 / $113.64	Professional	26	$25.38	$29.86	$113.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.03 / $34.95 / $67.86	Professional	TC	$31.03	$34.95	$67.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $87.26 / $206.19	Professional		$57.75	$87.26	$206.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.09 / $39.46 / $92.09	Professional	26	$28.09	$39.46	$92.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $47.80 / $111.16	Professional	TC	$29.49	$47.80	$111.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.09 / $84.24 / $129.22	Facility	26	$72.09	$84.24	$129.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $160.16 / $203.64	Professional		$73.56	$160.16	$203.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.64 / $65.63 / $79.33	Professional	26	$31.64	$65.63	$79.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $90.39 / $121.18	Professional	TC	$39.84	$90.39	$121.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $64.69 / $122.62 / $122.62	Facility	26	$64.69	$122.62	$122.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $115.57 / $717.26	Professional		$60.27	$115.57	$717.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $53.82 / $330.63	Professional	26	$29.23	$53.82	$330.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.04 / $55.54 / $563.89	Professional	TC	$31.04	$55.54	$563.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $56.50 / $123.75	Professional		$25.07	$56.50	$123.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.50 / $160.38 / $414.42	Professional		$104.50	$160.38	$414.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $36.47 / $122.62 / $122.62	Facility	26	$36.47	$122.62	$122.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.83 / $317.45 / $717.26	Professional		$96.83	$317.45	$717.26
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $42.18 / $141.94 / $330.63	Professional	26	$42.18	$141.94	$330.63
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $55.07 / $281.17 / $563.89	Professional	TC	$55.07	$281.17	$563.89
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.47 / $39.47 / $39.47	Facility	26	$39.47	$39.47	$39.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.37 / $221.83 / $293.63	Professional		$91.37	$221.83	$293.63
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.32 / $44.54 / $65.63	Professional	26	$34.32	$44.54	$65.63
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.42 / $50.55 / $84.98	Professional	TC	$40.42	$50.55	$84.98
United Facility/Professional Professional Modifier Low / Median / High Price $58.77 / $94.37 / $201.68	Professional		$58.77	$94.37	$201.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $45.09 / $94.91	Professional	26	$29.14	$45.09	$94.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.33 / $47.81 / $109.61	Professional	TC	$30.33	$47.81	$109.61