Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $14.47 / $17.48	Facility	26	$12.59	$14.47	$17.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.17 / $57.16 / $187.00	Professional		$33.17	$57.16	$187.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $12.59 / $62.05	Professional	26	$7.50	$12.59	$62.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $36.28 / $142.00	Professional	TC	$25.57	$36.28	$142.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $75.39 / $206.04	Professional		$33.72	$75.39	$206.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $18.76 / $52.25	Professional	26	$8.11	$18.76	$52.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.64 / $56.65 / $160.57	Professional	TC	$24.64	$56.65	$160.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.73 / $24.22 / $32.19	Facility	26	$20.73	$24.22	$32.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $131.82 / $149.80	Professional		$35.47	$131.82	$149.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $28.26 / $32.11	Professional	26	$9.52	$28.26	$32.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $103.57 / $117.69	Professional	TC	$26.56	$103.57	$117.69
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 $36.97 / $86.98 / $245.68	Professional		$36.97	$86.98	$245.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $22.50 / $61.09	Professional	26	$9.72	$22.50	$61.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $67.53 / $192.57	Professional	TC	$27.79	$67.53	$192.57
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 $73.45 / $110.04 / $150.07	Professional		$73.45	$110.04	$150.07
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 $55.53 / $173.95 / $245.68	Professional		$55.53	$173.95	$245.68
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $43.25 / $61.09	Professional	26	$13.10	$43.25	$61.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $43.62 / $130.75 / $192.57	Professional	TC	$43.62	$130.75	$192.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $216.11 / $234.92	Professional		$69.95	$216.11	$234.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $24.37 / $47.48	Professional	26	$19.26	$24.37	$47.48
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.70 / $60.69 / $143.84	Professional	TC	$50.70	$60.69	$143.84
United Facility/Professional Professional Modifier Low / Median / High Price $36.81 / $73.95 / $152.47	Professional		$36.81	$73.95	$152.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $18.38 / $37.90	Professional	26	$9.35	$18.38	$37.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $54.37 / $114.56	Professional	TC	$27.79	$54.37	$114.56