Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.37 / $104.37 / $211.97	Facility	26	$104.37	$104.37	$211.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $423.65 / $473.97 / $807.36	Professional		$423.65	$473.97	$807.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.16 / $77.31 / $552.50	Professional	26	$56.16	$77.31	$552.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $365.10 / $411.86 / $718.15	Professional	TC	$365.10	$411.86	$718.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.89 / $593.32 / $1,877.01	Professional		$400.89	$593.32	$1,877.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.70 / $81.30 / $248.31	Professional	26	$58.70	$81.30	$248.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $338.72 / $512.01 / $1,628.70	Professional	TC	$338.72	$512.01	$1,628.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.59 / $174.80 / $268.14	Facility	26	$149.59	$174.80	$268.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.59 / $1,146.05 / $2,029.16	Professional		$533.59	$1,146.05	$2,029.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.56 / $142.72 / $268.43	Professional	26	$72.56	$142.72	$268.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $456.55 / $1,003.33 / $1,760.74	Professional	TC	$456.55	$1,003.33	$1,760.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $520.74 / $1,098.13 / $3,905.69	Professional		$520.74	$1,098.13	$3,905.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $79.14 / $160.03 / $617.51	Professional	26	$79.14	$160.03	$617.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $440.03 / $943.09 / $3,576.06	Professional	TC	$440.03	$943.09	$3,576.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $346.91 / $847.54	Professional		$58.40	$346.91	$847.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $442.76 / $1,004.50 / $1,447.60	Professional		$442.76	$1,004.50	$1,447.60
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $416.00 / $416.00 / $416.00	Facility	26	$416.00	$416.00	$416.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $620.15 / $2,226.19 / $3,905.69	Professional		$620.15	$2,226.19	$3,905.69
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $95.20 / $358.88 / $617.51	Professional	26	$95.20	$358.88	$617.51
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $576.09 / $1,927.79 / $3,576.06	Professional	TC	$576.09	$1,927.79	$3,576.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $351.80 / $2,208.73 / $2,208.73	Professional		$351.80	$2,208.73	$2,208.73
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.76 / $148.38 / $334.55	Professional	26	$71.76	$148.38	$334.55
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $440.22 / $900.61 / $2,119.17	Professional	TC	$440.22	$900.61	$2,119.17
United Facility/Professional Professional Modifier Low / Median / High Price $508.13 / $887.62 / $1,544.75	Professional		$508.13	$887.62	$1,544.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.02 / $140.69 / $266.70	Professional	26	$71.02	$140.69	$266.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $433.68 / $761.68 / $1,331.55	Professional	TC	$433.68	$761.68	$1,331.55