Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.62 / $48.62 / $167.46	Facility	26	$48.62	$48.62	$167.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.01 / $250.88 / $816.00	Professional		$90.01	$250.88	$816.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.83 / $83.77 / $502.98	Professional	26	$43.83	$83.77	$502.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $612.82 / $624.00 / $1,034.09	Professional	50	$612.82	$624.00	$1,034.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.17 / $56.97 / $92.65	Professional	TC	$40.17	$56.97	$92.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $139.53 / $410.48	Professional		$88.68	$139.53	$410.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.29 / $64.25 / $194.39	Professional	26	$44.29	$64.25	$194.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.21 / $75.28 / $226.82	Professional	TC	$42.21	$75.28	$226.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.62 / $54.21 / $107.76	Professional		$47.62	$54.21	$107.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.05 / $137.94 / $211.61	Facility	26	$118.05	$137.94	$211.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.23 / $245.58 / $309.45	Professional		$101.23	$245.58	$309.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.71 / $113.44 / $145.83	Professional	26	$55.71	$113.44	$145.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.52 / $132.15 / $166.82	Professional	TC	$57.52	$132.15	$166.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $251.00 / $251.00 / $251.00	Facility	26	$251.00	$251.00	$251.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.81 / $228.06 / $641.76	Professional		$111.81	$228.06	$641.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.79 / $114.43 / $283.72	Professional	26	$56.79	$114.43	$283.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $52.66 / $115.41 / $358.05	Professional	TC	$52.66	$115.41	$358.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $65.00 / $190.18	Professional		$25.98	$65.00	$190.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.19 / $215.96 / $308.00	Professional		$151.19	$215.96	$308.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $201.33 / $201.33 / $201.33	Facility	26	$201.33	$201.33	$201.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.27 / $475.45 / $641.76	Professional		$139.27	$475.45	$641.76
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $64.33 / $228.85 / $283.72	Professional	26	$64.33	$228.85	$283.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $246.60 / $358.05	Professional	TC	$69.18	$246.60	$358.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $137.80 / $396.48 / $495.99	Professional		$137.80	$396.48	$495.99
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.34 / $113.90 / $147.05	Professional	26	$56.34	$113.90	$147.05
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.58 / $109.39 / $142.43	Professional	TC	$68.58	$109.39	$142.43
United Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $186.05 / $356.59	Professional		$99.25	$186.05	$356.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.13 / $95.26 / $176.26	Professional	26	$52.13	$95.26	$176.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.66 / $92.74 / $184.95	Professional	TC	$53.66	$92.74	$184.95