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 / $164.37	Facility	26	$47.98	$47.98	$164.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.86 / $148.08 / $627.00	Professional		$113.86	$148.08	$627.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.77 / $47.98 / $81.00	Professional	26	$41.77	$47.98	$81.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.30 / $105.15 / $153.26	Professional	TC	$71.30	$105.15	$153.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.92 / $149.60 / $460.56	Professional		$118.92	$149.60	$460.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $57.40 / $143.91	Professional	26	$43.75	$57.40	$143.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.08 / $95.71 / $314.68	Professional	TC	$76.08	$95.71	$314.68
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 $151.72 / $310.70 / $441.00	Professional		$151.72	$310.70	$441.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.69 / $112.19 / $159.80	Professional	26	$54.69	$112.19	$159.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.44 / $198.51 / $281.20	Professional	TC	$94.44	$198.51	$281.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $319.02 / $944.58	Professional		$140.00	$319.02	$944.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.76 / $113.48 / $386.24	Professional	26	$52.76	$113.48	$386.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.15 / $211.68 / $782.04	Professional	TC	$85.15	$211.68	$782.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $105.02 / $253.92	Professional		$38.69	$105.02	$253.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $272.27 / $381.88	Professional		$133.91	$272.27	$381.88
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $198.29 / $198.29 / $198.29	Facility	26	$198.29	$198.29	$198.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $193.98 / $624.85 / $944.58	Professional		$193.98	$624.85	$944.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $73.83 / $226.95 / $386.24	Professional	26	$73.83	$226.95	$386.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $130.63 / $397.85 / $782.04	Professional	TC	$130.63	$397.85	$782.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $277.06 / $627.52 / $627.52	Professional		$277.06	$627.52	$627.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.62 / $115.06 / $145.59	Professional	26	$55.62	$115.06	$145.59
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $101.13 / $232.22 / $643.95	Professional	TC	$101.13	$232.22	$643.95
United Facility/Professional Professional Modifier Low / Median / High Price $137.24 / $274.48 / $470.64	Professional		$137.24	$274.48	$470.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.02 / $95.41 / $173.92	Professional	26	$51.02	$95.41	$173.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.94 / $174.46 / $307.25	Professional	TC	$83.94	$174.46	$307.25