Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $18.23 / $18.23	Facility	26	$13.11	$18.23	$18.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $44.02 / $249.10	Professional		$28.32	$44.02	$249.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $13.32 / $99.75	Professional	26	$7.82	$13.32	$99.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.24 / $650.00 / $650.00	Professional	50	$59.24	$650.00	$650.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $30.34 / $65.77	Professional	TC	$18.53	$30.34	$65.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.01 / $64.23 / $177.21	Professional		$29.01	$64.23	$177.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $18.73 / $54.29	Professional	26	$8.46	$18.73	$54.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.52 / $103.98 / $291.89	Professional	50	$43.52	$103.98	$291.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $46.12 / $131.49	Professional	TC	$20.53	$46.12	$131.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.68 / $28.25 / $44.55	Professional		$9.68	$28.25	$44.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $25.27 / $33.59	Facility	26	$21.63	$25.27	$33.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.05 / $114.30 / $129.88	Professional		$31.05	$114.30	$129.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $29.48 / $33.50	Professional	26	$9.51	$29.48	$33.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $84.83 / $96.40	Professional	TC	$21.84	$84.83	$96.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $198.00	Facility	26	$100.00	$100.00	$198.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.77 / $74.15 / $208.77	Professional		$31.77	$74.15	$208.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $21.71 / $82.56	Professional	26	$9.49	$21.71	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $54.15 / $153.47	Professional	TC	$22.74	$54.15	$153.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $74.33	Professional		$19.34	$33.89	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $96.41 / $131.13	Professional		$64.34	$96.41	$131.13
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.14 / $148.30 / $208.77	Professional		$48.14	$148.30	$208.77
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $41.55 / $82.56	Professional	26	$13.57	$41.55	$82.56
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $106.75 / $153.47	Professional	TC	$35.72	$106.75	$153.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.29 / $183.02 / $203.66	Professional		$59.29	$183.02	$203.66
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $23.41 / $45.62	Professional	26	$18.50	$23.41	$45.62
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $57.12 / $119.43	Professional	TC	$40.78	$57.12	$119.43
United Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $64.25 / $129.97	Professional		$31.40	$64.25	$129.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $55.19 / $95.00	Professional	26	$10.39	$55.19	$95.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.49 / $43.79 / $93.56	Professional	TC	$22.49	$43.79	$93.56