Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.64 / $20.34 / $20.34	Facility	26	$14.64	$20.34	$20.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.06 / $33.89 / $66.56	Professional		$28.06	$33.89	$66.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.00 / $21.76	Professional	26	$8.71	$10.00	$21.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.35 / $23.94 / $55.89	Professional	TC	$19.35	$23.94	$55.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.11 / $63.83 / $184.93	Professional		$30.11	$63.83	$184.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $21.81 / $60.74	Professional	26	$9.44	$21.81	$60.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.37 / $44.31 / $122.40	Professional	TC	$20.37	$44.31	$122.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.33 / $28.43 / $37.79	Facility	26	$24.33	$28.43	$37.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $112.02 / $127.30	Professional		$37.14	$112.02	$127.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $33.04 / $37.54	Professional	26	$10.58	$33.04	$37.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $78.94 / $89.70	Professional	TC	$26.89	$78.94	$89.70
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 $33.45 / $78.14 / $206.60	Professional		$33.45	$78.14	$206.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $26.01 / $78.44	Professional	26	$10.96	$26.01	$78.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $52.78 / $193.00	Professional	TC	$22.00	$52.78	$193.00
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 $62.40 / $93.48 / $132.51	Professional		$62.40	$93.48	$132.51
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 $50.66 / $150.19 / $206.60	Professional		$50.66	$150.19	$206.60
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.32 / $50.30 / $78.44	Professional	26	$15.32	$50.30	$78.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $99.90 / $193.00	Professional	TC	$34.29	$99.90	$193.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.93 / $183.14 / $199.59	Professional		$63.93	$183.14	$199.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $29.29 / $55.17	Professional	26	$23.15	$29.29	$55.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $51.60 / $115.66	Professional	TC	$40.78	$51.60	$115.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $67.41 / $131.65	Professional		$31.83	$67.41	$131.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $23.02 / $44.09	Professional	26	$10.47	$23.02	$44.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.29 / $46.92 / $87.56	Professional	TC	$21.29	$46.92	$87.56