Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.80 / $21.63 / $26.12	Facility	26	$18.80	$21.63	$26.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $62.36 / $231.00	Professional		$40.88	$62.36	$231.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $16.73 / $68.00	Professional	26	$11.20	$16.73	$68.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $41.92 / $76.18	Professional	TC	$27.55	$41.92	$76.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.23 / $92.81 / $259.08	Professional		$43.23	$92.81	$259.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $28.04 / $78.11	Professional	26	$12.14	$28.04	$78.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.68 / $66.68 / $189.65	Professional	TC	$29.68	$66.68	$189.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.44 / $37.90 / $50.38	Facility	26	$32.44	$37.90	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $166.31 / $188.99	Professional		$48.98	$166.31	$188.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.38 / $43.98 / $49.98	Professional	26	$14.38	$43.98	$49.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $122.33 / $139.01	Professional	TC	$33.97	$122.33	$139.01
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 $47.84 / $111.06 / $306.22	Professional		$47.84	$111.06	$306.22
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $34.51 / $95.76	Professional	26	$14.50	$34.51	$95.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.85 / $79.89 / $250.00	Professional	TC	$32.85	$79.89	$250.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $43.33 / $77.04	Professional		$19.34	$43.33	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $136.33 / $211.73	Professional		$91.00	$136.33	$211.73
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 $71.66 / $221.05 / $306.22	Professional		$71.66	$221.05	$306.22
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $66.34 / $95.76	Professional	26	$20.38	$66.34	$95.76
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $51.52 / $154.69 / $250.00	Professional	TC	$51.52	$154.69	$250.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $269.94 / $296.32	Professional		$89.34	$269.94	$296.32
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.49 / $37.31 / $70.73	Professional	26	$29.49	$37.31	$70.73
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.85 / $75.73 / $172.01	Professional	TC	$59.85	$75.73	$172.01
United Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $95.16 / $193.15	Professional		$45.60	$95.16	$193.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $30.57 / $58.16	Professional	26	$13.71	$30.57	$58.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.85 / $72.66 / $135.59	Professional	TC	$32.85	$72.66	$135.59