Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.30 / $108.30 / $218.63	Facility	26	$108.30	$108.30	$218.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.64 / $489.69 / $757.32	Professional		$393.64	$489.69	$757.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.55 / $66.12 / $108.30	Professional	26	$56.55	$66.12	$108.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $183.90 / $243.12 / $352.43	Professional	52	$183.90	$243.12	$352.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $331.36 / $430.20 / $668.76	Professional	TC	$331.36	$430.20	$668.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $418.17 / $549.04 / $1,605.07	Professional		$418.17	$549.04	$1,605.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.37 / $84.36 / $256.60	Professional	26	$61.37	$84.36	$256.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $356.81 / $471.63 / $1,347.72	Professional	TC	$356.81	$471.63	$1,347.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.99 / $181.12 / $277.83	Facility	26	$154.99	$181.12	$277.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.35 / $1,081.57 / $1,925.99	Professional		$519.35	$1,081.57	$1,925.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.00 / $147.02 / $277.39	Professional	26	$75.00	$147.02	$277.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $438.20 / $934.55 / $1,648.59	Professional	TC	$438.20	$934.55	$1,648.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $530.16 / $1,016.03 / $2,899.13	Professional		$530.16	$1,016.03	$2,899.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $81.92 / $156.13 / $873.43	Professional	26	$81.92	$156.13	$873.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $439.97 / $875.98 / $2,483.58	Professional	TC	$439.97	$875.98	$2,483.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $337.08 / $810.36	Professional		$58.40	$337.08	$810.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $373.36 / $956.34 / $1,410.42	Professional		$373.36	$956.34	$1,410.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $495.00 / $495.00 / $495.00	Facility	26	$495.00	$495.00	$495.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $623.21 / $1,963.55 / $2,899.13	Professional		$623.21	$1,963.55	$2,899.13
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $98.38 / $315.52 / $873.43	Professional	26	$98.38	$315.52	$873.43
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $536.40 / $1,657.75 / $2,483.58	Professional	TC	$536.40	$1,657.75	$2,483.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $397.19 / $1,530.76 / $2,096.42	Professional		$397.19	$1,530.76	$2,096.42
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.59 / $156.07 / $197.48	Professional	26	$74.59	$156.07	$197.48
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $390.62 / $983.96 / $1,302.64	Professional	TC	$390.62	$983.96	$1,302.64
United Facility/Professional Professional Modifier Low / Median / High Price $479.04 / $908.39 / $1,516.21	Professional		$479.04	$908.39	$1,516.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.43 / $133.59 / $231.34	Professional	26	$68.43	$133.59	$231.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $411.27 / $772.23 / $1,280.08	Professional	TC	$411.27	$772.23	$1,280.08