Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.36 / $23.41 / $28.28	Facility	26	$20.36	$23.41	$28.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $46.57 / $65.03 / $386.10	Facility	TC	$46.57	$65.03	$386.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.25 / $61.87 / $145.44	Professional		$39.25	$61.87	$145.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $20.34 / $76.88	Professional	26	$12.12	$20.34	$76.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $34.89 / $61.84	Professional	TC	$27.17	$34.89	$61.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.18 / $97.14 / $276.80	Professional		$43.18	$97.14	$276.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $30.35 / $84.55	Professional	26	$13.14	$30.35	$84.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.32 / $61.42 / $170.47	Professional	TC	$29.32	$61.42	$170.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.14 / $41.07 / $54.58	Facility	26	$35.14	$41.07	$54.58
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $85.61 / $100.04 / $132.96	Facility	TC	$85.61	$100.04	$132.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.40 / $157.04 / $178.45	Professional		$57.40	$157.04	$178.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.34 / $47.59 / $54.08	Professional	26	$18.34	$47.59	$54.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.06 / $109.45 / $124.38	Professional	TC	$39.06	$109.45	$124.38
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 Facility Modifier TC Low / Median / High Price $142.32 / $142.32 / $481.08	Facility	TC	$142.32	$142.32	$481.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.67 / $110.63 / $314.00	Professional		$47.67	$110.63	$314.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $38.83 / $107.32	Professional	26	$16.32	$38.83	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.04 / $74.48 / $296.00	Professional	TC	$31.04	$74.48	$296.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.32 / $77.04	Professional		$19.71	$46.32	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $130.49 / $261.76	Professional		$87.10	$130.49	$261.76
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 Facility Modifier TC Low / Median / High Price $100.00 / $142.32 / $142.32	Facility	TC	$100.00	$142.32	$142.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.65 / $212.65 / $314.00	Professional		$74.65	$212.65	$314.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $71.65 / $107.32	Professional	26	$22.05	$71.65	$107.32
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.08 / $141.00 / $296.00	Professional	TC	$48.08	$141.00	$296.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.38 / $267.81 / $279.79	Professional		$98.38	$267.81	$279.79
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.53 / $48.75 / $93.90	Professional	26	$38.53	$48.75	$93.90
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.85 / $80.69 / $173.91	Professional	TC	$59.85	$80.69	$173.91
United Facility/Professional Professional Modifier Low / Median / High Price $47.36 / $99.28 / $201.86	Professional		$47.36	$99.28	$201.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $34.54 / $78.86	Professional	26	$15.98	$34.54	$78.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.95 / $65.62 / $123.59	Professional	TC	$29.95	$65.62	$123.59