Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.66 / $21.06 / $21.06	Facility	26	$14.66	$21.06	$21.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.76 / $21.22 / $39.42	Professional		$15.76	$21.22	$39.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $14.66 / $59.98	Professional	26	$8.75	$14.66	$59.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.02 / $11.48 / $16.60	Professional	TC	$7.02	$11.48	$16.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.29 / $39.83 / $108.91	Professional		$17.29	$39.83	$108.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $22.48 / $60.87	Professional	26	$9.46	$22.48	$60.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $7.83 / $17.23 / $48.03	Professional	TC	$7.83	$17.23	$48.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.31 / $12.77 / $27.69	Professional		$9.31	$12.77	$27.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.23 / $29.48 / $39.19	Facility	26	$25.23	$29.48	$39.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.53 / $64.00 / $72.73	Professional		$26.53	$64.00	$72.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $34.29 / $38.97	Professional	26	$11.39	$34.29	$38.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.49 / $29.70 / $33.75	Professional	TC	$12.49	$29.70	$33.75
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 $20.99 / $49.90 / $206.87	Professional		$20.99	$49.90	$206.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $27.11 / $105.66	Professional	26	$11.69	$27.11	$105.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $9.59 / $25.24 / $129.58	Professional	TC	$9.59	$25.24	$129.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.28 / $35.07 / $70.00	Professional		$14.28	$35.07	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $55.51 / $199.48	Professional		$37.04	$55.51	$199.48
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 $30.43 / $100.98 / $206.87	Professional		$30.43	$100.98	$206.87
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $52.10 / $105.66	Professional	26	$15.88	$52.10	$105.66
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $69.22 / $129.58	Professional	TC	$14.13	$69.22	$129.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $114.06 / $114.06	Professional		$44.50	$114.06	$114.06
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.31 / $30.76 / $60.88	Professional	26	$24.31	$30.76	$60.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.16 / $20.19 / $57.42	Professional	TC	$17.16	$20.19	$57.42
United Facility/Professional Professional Modifier Low / Median / High Price $20.70 / $44.37 / $80.78	Professional		$20.70	$44.37	$80.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $24.37 / $45.67	Professional	26	$10.83	$24.37	$45.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.83 / $19.95 / $44.85	Professional	TC	$8.83	$19.95	$44.85