Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.71 / $80.26 / $162.88	Facility	26	$46.71	$80.26	$162.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.01 / $170.64 / $600.00	Professional		$97.01	$170.64	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.74 / $80.26 / $514.55	Professional	26	$47.74	$80.26	$514.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.61 / $84.07 / $179.31	Professional	52	$46.61	$84.07	$179.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.38 / $91.62 / $207.71	Professional	TC	$51.38	$91.62	$207.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.73 / $181.41 / $487.94	Professional		$109.73	$181.41	$487.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.16 / $73.50 / $190.79	Professional	26	$48.16	$73.50	$190.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.35 / $113.63 / $279.27	Professional	TC	$57.35	$113.63	$279.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.14 / $56.87 / $111.10	Professional		$47.14	$56.87	$111.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.34 / $134.79 / $206.77	Facility	26	$115.34	$134.79	$206.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.14 / $253.32 / $446.25	Professional		$123.14	$253.32	$446.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.32 / $110.05 / $206.25	Professional	26	$59.32	$110.05	$206.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.12 / $141.51 / $240.00	Professional	TC	$65.12	$141.51	$240.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $455.67 / $455.67 / $455.67	Facility	26	$455.67	$455.67	$455.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.30 / $335.80 / $3,000.00	Professional		$175.30	$335.80	$3,000.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $67.45 / $134.55 / $870.13	Professional	26	$67.45	$134.55	$870.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $105.50 / $204.22 / $870.13	Professional	TC	$105.50	$204.22	$870.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $81.10 / $191.96	Professional		$38.69	$81.10	$191.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $155.52 / $228.10 / $967.60	Professional		$155.52	$228.10	$967.60
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $333.99 / $333.99 / $333.99	Facility	26	$333.99	$333.99	$333.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.01 / $778.35 / $3,000.00	Professional		$182.01	$778.35	$3,000.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $77.09 / $318.33 / $870.13	Professional	26	$77.09	$318.33	$870.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $102.15 / $460.02 / $870.13	Professional	TC	$102.15	$460.02	$870.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $226.26 / $485.78 / $648.48	Professional		$226.26	$485.78	$648.48
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.27 / $153.90 / $295.29	Professional	26	$55.27	$153.90	$295.29
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.62 / $264.33 / $363.44	Professional	TC	$57.62	$264.33	$363.44
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $304.89 / $445.99	Professional		$95.00	$304.89	$445.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.57 / $112.18 / $185.56	Professional	26	$60.57	$112.18	$185.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.58 / $183.43 / $326.02	Professional	TC	$87.58	$183.43	$326.02