Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.98 / $47.98 / $163.97	Facility	26	$47.98	$47.98	$163.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $94.61 / $142.41	Professional		$78.95	$94.61	$142.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $47.98 / $79.20	Professional	26	$39.95	$47.98	$79.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.35 / $46.63 / $74.48	Professional	TC	$37.35	$46.63	$74.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.84 / $104.74 / $270.02	Professional		$76.84	$104.74	$270.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.13 / $57.00 / $142.82	Professional	26	$43.13	$57.00	$142.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.45 / $51.63 / $127.22	Professional	TC	$31.45	$51.63	$127.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.24 / $135.84 / $208.38	Facility	26	$116.24	$135.84	$208.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.64 / $224.00 / $290.00	Professional		$98.64	$224.00	$290.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.54 / $111.89 / $159.80	Professional	26	$54.54	$111.89	$159.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.15 / $112.11 / $144.75	Professional	TC	$48.15	$112.11	$144.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.70 / $200.55 / $567.30	Professional		$87.70	$200.55	$567.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.22 / $112.90 / $318.67	Professional	26	$51.22	$112.90	$318.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.47 / $90.84 / $318.67	Professional	TC	$30.47	$90.84	$318.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $64.69 / $190.84	Professional		$25.36	$64.69	$190.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $199.43 / $280.19	Professional		$133.91	$199.43	$280.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $196.79 / $196.79 / $196.79	Facility	26	$196.79	$196.79	$196.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $127.03 / $419.90 / $567.30	Professional		$127.03	$419.90	$567.30
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $73.63 / $225.80 / $318.67	Professional	26	$73.63	$225.80	$318.67
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $64.51 / $194.10 / $318.67	Professional	TC	$64.51	$194.10	$318.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $178.98 / $345.92 / $452.42	Professional		$178.98	$345.92	$452.42
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.62 / $113.78 / $143.97	Professional	26	$55.62	$113.78	$143.97
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.99 / $96.78 / $135.32	Professional	TC	$54.99	$96.78	$135.32
United Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $176.55 / $322.61	Professional		$83.78	$176.55	$322.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.94 / $90.58 / $169.35	Professional	26	$50.94	$90.58	$169.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.47 / $79.39 / $145.58	Professional	TC	$30.47	$79.39	$145.58