Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $17.48 / $17.48	Facility	26	$12.59	$17.48	$17.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $44.17 / $168.00	Professional		$28.03	$44.17	$168.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $9.94 / $19.07	Professional	26	$7.53	$9.94	$19.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $27.68 / $57.84	Professional	TC	$20.39	$27.68	$57.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $63.76 / $184.69	Professional		$31.04	$63.76	$184.69
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 $21.85 / $46.95 / $129.66	Professional	TC	$21.85	$46.95	$129.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $25.27 / $33.59	Facility	26	$21.63	$25.27	$33.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $113.09 / $128.51	Professional		$36.39	$113.09	$128.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $29.44 / $33.45	Professional	26	$9.52	$29.44	$33.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $83.66 / $95.06	Professional	TC	$26.89	$83.66	$95.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $142.00	Facility	26	$100.00	$100.00	$142.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.01 / $77.15 / $208.83	Professional		$33.01	$77.15	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $22.50 / $66.04	Professional	26	$9.55	$22.50	$66.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $55.50 / $188.00	Professional	TC	$23.14	$55.50	$188.00
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 $63.05 / $94.46 / $127.06	Professional		$63.05	$94.46	$127.06
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 $52.29 / $148.30 / $208.83	Professional		$52.29	$148.30	$208.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $43.25 / $66.04	Professional	26	$13.64	$43.25	$66.04
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $36.94 / $105.05 / $188.00	Professional	TC	$36.94	$105.05	$188.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.86 / $182.91 / $201.53	Professional		$63.86	$182.91	$201.53
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 $44.60 / $57.12 / $128.81	Professional	TC	$44.60	$57.12	$128.81
United Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $69.65 / $130.15	Professional		$31.57	$69.65	$130.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $20.30 / $37.90	Professional	26	$9.44	$20.30	$37.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $48.40 / $92.07	Professional	TC	$22.38	$48.40	$92.07