Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.71 / $21.83 / $21.83	Facility	26	$15.71	$21.83	$21.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $56.30 / $323.00	Professional		$32.74	$56.30	$323.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.71 / $63.96	Professional	26	$9.36	$15.71	$63.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $35.43 / $60.32	Professional	TC	$23.70	$35.43	$60.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $80.18 / $231.16	Professional		$36.32	$80.18	$231.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $23.42 / $65.25	Professional	26	$10.14	$23.42	$65.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.80 / $53.53 / $150.43	Professional	TC	$25.80	$53.53	$150.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.59 / $32.67 / $50.96	Professional		$11.59	$32.67	$50.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.03 / $31.59 / $41.99	Facility	26	$27.03	$31.59	$41.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $132.12 / $150.13	Professional		$47.71	$132.12	$150.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $36.72 / $41.74	Professional	26	$13.73	$36.72	$41.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $95.35 / $108.35	Professional	TC	$33.97	$95.35	$108.35
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 $39.22 / $91.64 / $262.00	Professional		$39.22	$91.64	$262.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $29.43 / $107.32	Professional	26	$12.70	$29.43	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $63.64 / $249.00	Professional	TC	$26.53	$63.64	$249.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $40.15 / $77.04	Professional		$19.34	$40.15	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.45 / $110.04 / $163.88	Professional		$73.45	$110.04	$163.88
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 $61.53 / $176.15 / $262.00	Professional		$61.53	$176.15	$262.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $55.70 / $107.32	Professional	26	$17.02	$55.70	$107.32
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $42.18 / $120.45 / $249.00	Professional	TC	$42.18	$120.45	$249.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.92 / $222.01 / $235.39	Professional		$80.92	$222.01	$235.39
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.93 / $35.34 / $68.78	Professional	26	$27.93	$35.34	$68.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $67.05 / $153.25	Professional	TC	$52.99	$67.05	$153.25
United Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $82.73 / $154.58	Professional		$37.52	$82.73	$154.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.07 / $25.66 / $48.83	Professional	26	$12.07	$25.66	$48.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.33 / $57.64 / $105.70	Professional	TC	$26.33	$57.64	$105.70