Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.79 / $20.45 / $25.40	Facility	26	$17.79	$20.45	$25.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $55.93 / $194.04	Professional		$35.67	$55.93	$194.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $16.30 / $45.27	Professional	26	$10.60	$16.30	$45.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $36.33 / $84.60	Professional	TC	$25.05	$36.33	$84.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $85.53 / $237.76	Professional		$39.47	$85.53	$237.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $26.52 / $73.87	Professional	26	$11.48	$26.52	$73.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.86 / $60.63 / $173.29	Professional	TC	$26.86	$60.63	$173.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.64 / $35.79 / $47.59	Facility	26	$30.64	$35.79	$47.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $153.35 / $174.26	Professional		$42.23	$153.35	$174.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.84 / $41.59 / $47.26	Professional	26	$13.84	$41.59	$47.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.30 / $111.77 / $127.01	Professional	TC	$29.30	$111.77	$127.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $101.90 / $282.36	Professional		$43.65	$101.90	$282.36
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.03 / $32.65 / $90.81	Professional	26	$14.03	$32.65	$90.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.16 / $71.64 / $211.00	Professional	TC	$30.16	$71.64	$211.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $41.16 / $77.04	Professional		$19.34	$41.16	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.15 / $127.57 / $196.00	Professional		$85.15	$127.57	$196.00
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 $67.11 / $203.80 / $282.36	Professional		$67.11	$203.80	$282.36
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $62.80 / $90.81	Professional	26	$19.26	$62.80	$90.81
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $47.08 / $141.00 / $211.00	Professional	TC	$47.08	$141.00	$211.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $248.31 / $273.26	Professional		$81.68	$248.31	$273.26
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.93 / $35.34 / $68.78	Professional	26	$27.93	$35.34	$68.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.75 / $68.54 / $157.00	Professional	TC	$53.75	$68.54	$157.00
United Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $74.01 / $168.91	Professional		$42.95	$74.01	$168.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $61.13 / $96.66	Professional	26	$20.89	$61.13	$96.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.96 / $63.19 / $129.99	Professional	TC	$29.96	$63.19	$129.99