Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.53 / $49.53 / $168.46	Facility	26	$49.53	$49.53	$168.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.05 / $104.58 / $145.56	Professional		$81.05	$104.58	$145.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.84 / $55.04 / $78.02	Professional	TC	$42.84	$55.04	$78.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $115.78 / $309.29	Professional		$87.11	$115.78	$309.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.08 / $61.82 / $161.06	Professional	TC	$41.08	$61.82	$161.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.75 / $141.11 / $216.46	Facility	26	$120.75	$141.11	$216.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.22 / $241.45 / $329.51	Professional		$105.22	$241.45	$329.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.97 / $125.11 / $165.99	Professional	TC	$53.97	$125.11	$165.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $229.04 / $646.83	Professional		$100.69	$229.04	$646.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $115.11 / $354.71	Professional	TC	$39.47	$115.11	$354.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $65.00 / $190.84	Professional		$25.36	$65.00	$190.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.74 / $205.17 / $287.76	Professional		$140.74	$205.17	$287.76
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $202.83 / $202.83 / $202.83	Facility	26	$202.83	$202.83	$202.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $478.70 / $646.83	Professional		$134.18	$478.70	$646.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $70.95 / $239.20 / $354.71	Professional	TC	$70.95	$239.20	$354.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $208.62 / $409.96 / $487.69	Professional		$208.62	$409.96	$487.69
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.59 / $125.43 / $179.92	Professional	TC	$67.59	$125.43	$179.92
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $202.66 / $359.03	Professional		$97.72	$202.66	$359.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.01 / $99.20 / $179.40	Professional	TC	$43.01	$99.20	$179.40