Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.91 / $108.91 / $375.26	Facility	26	$108.91	$108.91	$375.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.83 / $322.24 / $515.27	Professional		$264.83	$322.24	$515.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.31 / $108.91 / $165.13	Professional	26	$94.31	$108.91	$165.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.33 / $201.66 / $359.50	Professional	TC	$173.33	$201.66	$359.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.50 / $392.78 / $1,174.26	Professional		$238.50	$392.78	$1,174.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.07 / $143.91 / $435.97	Professional	26	$99.07	$143.91	$435.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.36 / $248.86 / $777.34	Professional	TC	$144.36	$248.86	$777.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.83 / $310.64 / $476.54	Facility	26	$265.83	$310.64	$476.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.31 / $746.34 / $961.15	Professional		$328.31	$746.34	$961.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.71 / $256.39 / $365.43	Professional	26	$123.71	$256.39	$365.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.82 / $489.95 / $638.58	Professional	TC	$204.82	$489.95	$638.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $273.02 / $642.65 / $2,013.87	Professional		$273.02	$642.65	$2,013.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $116.59 / $255.75 / $716.57	Professional	26	$116.59	$255.75	$716.57
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $155.19 / $389.93 / $1,590.04	Professional	TC	$155.19	$389.93	$1,590.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.83 / $198.93 / $555.06	Professional		$80.83	$198.93	$555.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $470.34 / $670.67 / $958.10	Professional		$470.34	$670.67	$958.10
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $451.11 / $451.11 / $451.11	Facility	26	$451.11	$451.11	$451.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $423.25 / $1,263.02 / $2,013.87	Professional		$423.25	$1,263.02	$2,013.87
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $163.15 / $511.50 / $716.57	Professional	26	$163.15	$511.50	$716.57
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $277.85 / $829.13 / $1,590.04	Professional	TC	$277.85	$829.13	$1,590.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $638.92 / $1,390.60 / $1,507.45	Professional		$638.92	$1,390.60	$1,507.45
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $126.36 / $262.52 / $332.17	Professional	26	$126.36	$262.52	$332.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $195.88 / $489.17 / $1,079.60	Professional	TC	$195.88	$489.17	$1,079.60
United Facility/Professional Professional Modifier Low / Median / High Price $273.02 / $579.02 / $960.94	Professional		$273.02	$579.02	$960.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.99 / $207.48 / $383.63	Professional	26	$115.99	$207.48	$383.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.19 / $349.18 / $609.80	Professional	TC	$155.19	$349.18	$609.80