Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $21.88 / $26.30	Facility	26	$18.20	$21.88	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $58.88 / $169.82	Professional		$38.02	$58.88	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $19.05 / $42.66	Professional	26	$10.00	$19.05	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $83.18	Professional	TC	$25.70	$36.31	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $70.79 / $234.42	Professional		$43.65	$70.79	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.62 / $66.07	Professional	26	$12.02	$18.62	$66.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $51.29 / $158.49	Professional	TC	$29.51	$51.29	$158.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $38.02 / $60.26	Facility	26	$32.36	$38.02	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $109.65 / $194.98	Professional		$45.71	$109.65	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $26.92 / $51.29	Professional	26	$13.18	$26.92	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $74.13 / $141.25	Professional	TC	$33.11	$74.13	$141.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $102.33 / $138.04	Professional		$85.11	$102.33	$138.04
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $27.54 / $37.15	Professional	26	$23.44	$27.54	$37.15
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $74.13 / $102.33	Professional	TC	$63.10	$74.13	$102.33
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 $44.67 / $89.13 / $309.03	Professional		$44.67	$89.13	$309.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $27.54 / $95.50	Professional	26	$13.49	$27.54	$95.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $63.10 / $251.19	Professional	TC	$30.90	$63.10	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $213.80	Professional		$61.66	$120.23	$213.80
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 $50.12 / $218.78 / $309.03	Professional		$50.12	$218.78	$309.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $66.07 / $95.50	Professional	26	$15.85	$66.07	$95.50
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $154.88 / $251.19	Professional	TC	$35.48	$154.88	$251.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $213.80 / $295.12	Professional		$89.13	$213.80	$295.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $36.31 / $58.88	Professional	26	$29.51	$36.31	$58.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $74.13 / $154.88	Professional	TC	$60.26	$74.13	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $154.88	Professional		$43.65	$66.07	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $20.42 / $43.65	Professional	26	$13.18	$20.42	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $112.20	Professional	TC	$30.90	$45.71	$112.20