Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $28.18	Facility	26	$19.95	$19.95	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $50.12 / $107.15	Professional		$37.15	$50.12	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.20 / $41.69	Professional	26	$10.96	$18.20	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $70.79	Professional	TC	$25.12	$34.67	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $72.44 / $234.42	Professional		$45.71	$72.44	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $20.42 / $70.79	Professional	26	$13.18	$20.42	$70.79
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 $35.48 / $40.74 / $66.07	Facility	26	$35.48	$40.74	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $102.33 / $194.98	Professional		$46.77	$102.33	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $28.18 / $54.95	Professional	26	$14.13	$28.18	$54.95
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 $87.10 / $104.71 / $141.25	Professional		$87.10	$104.71	$141.25
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $39.81	Professional	26	$24.55	$30.20	$39.81
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 / $436.52	Professional		$44.67	$89.13	$436.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $28.84 / $97.72	Professional	26	$14.45	$28.84	$97.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $63.10 / $426.58	Professional	TC	$31.62	$63.10	$426.58
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 / $181.97	Professional		$61.66	$120.23	$181.97
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 $51.29 / $223.87 / $436.52	Professional		$51.29	$223.87	$436.52
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $69.18 / $97.72	Professional	26	$16.98	$69.18	$97.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $154.88 / $426.58	Professional	TC	$35.48	$154.88	$426.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $218.78 / $302.00	Professional		$91.20	$218.78	$302.00
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.02 / $64.57	Professional	26	$30.90	$38.02	$64.57
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 $44.67 / $67.61 / $158.49	Professional		$44.67	$67.61	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.38 / $47.86	Professional	26	$14.13	$21.38	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $112.20	Professional	TC	$30.90	$45.71	$112.20