Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.26 / $23.99 / $23.99	Facility	26	$17.26	$23.99	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $69.34 / $202.28	Professional		$45.98	$69.34	$202.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $14.98 / $40.40	Professional	26	$10.28	$14.98	$40.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $45.05 / $83.02	Professional	TC	$33.15	$45.05	$83.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.09 / $104.59 / $293.58	Professional		$48.09	$104.59	$293.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $25.73 / $71.68	Professional	26	$11.14	$25.73	$71.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.28 / $81.69 / $227.13	Professional	TC	$36.28	$81.69	$227.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.74 / $34.75 / $46.19	Facility	26	$29.74	$34.75	$46.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $186.14 / $211.53	Professional		$52.45	$186.14	$211.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.43 / $40.36 / $45.88	Professional	26	$13.43	$40.36	$45.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.01 / $145.77 / $165.65	Professional	TC	$39.01	$145.77	$165.65
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 $53.18 / $124.13 / $345.31	Professional		$53.18	$124.13	$345.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $31.74 / $142.00	Professional	26	$13.64	$31.74	$142.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $97.37 / $272.83	Professional	TC	$39.70	$97.37	$272.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $39.97 / $77.04	Professional		$19.34	$39.97	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $154.83 / $202.14	Professional		$103.35	$154.83	$202.14
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 $81.42 / $248.25 / $345.31	Professional		$81.42	$248.25	$345.31
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $61.00 / $142.00	Professional	26	$18.70	$61.00	$142.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $187.25 / $272.83	Professional	TC	$61.40	$187.25	$272.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.76 / $304.81 / $331.65	Professional		$103.76	$304.81	$331.65
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.90 / $35.29 / $68.69	Professional	26	$27.90	$35.29	$68.69
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.87 / $83.54 / $207.72	Professional	TC	$75.87	$83.54	$207.72
United Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $106.75 / $217.59	Professional		$52.33	$106.75	$217.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $26.23 / $53.47	Professional	26	$13.07	$26.23	$53.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $76.93 / $156.94	Professional	TC	$39.70	$76.93	$156.94