Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $15.07 / $18.23	Facility	26	$13.11	$15.07	$18.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.46 / $47.21 / $176.19	Professional		$27.46	$47.21	$176.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $14.20 / $67.58	Professional	26	$7.82	$14.20	$67.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $28.62 / $66.22	Professional	TC	$19.64	$28.62	$66.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $62.25 / $173.56	Professional		$29.14	$62.25	$173.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $18.73 / $54.29	Professional	26	$8.46	$18.73	$54.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $44.97 / $122.40	Professional	TC	$20.82	$44.97	$122.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.68 / $27.11 / $42.32	Professional		$9.68	$27.11	$42.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.53 / $26.33 / $34.99	Facility	26	$22.53	$26.33	$34.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.11 / $109.64 / $124.59	Professional		$30.11	$109.64	$124.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $30.66 / $34.84	Professional	26	$9.51	$30.66	$34.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.93 / $78.94 / $89.70	Professional	TC	$20.93	$78.94	$89.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $92.47 / $100.00 / $100.00	Facility	26	$92.47	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $73.33 / $202.27	Professional		$31.41	$73.33	$202.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.83 / $22.60 / $111.75	Professional	26	$9.83	$22.60	$111.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.66 / $52.83 / $146.99	Professional	TC	$21.66	$52.83	$146.99
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 $61.10 / $91.54 / $130.85	Professional		$61.10	$91.54	$130.85
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 $47.32 / $146.65 / $202.27	Professional		$47.32	$146.65	$202.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $45.05 / $111.75	Professional	26	$13.57	$45.05	$111.75
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $33.25 / $101.60 / $146.99	Professional	TC	$33.25	$101.60	$146.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $179.11 / $195.33	Professional		$60.05	$179.11	$195.33
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $23.41 / $45.62	Professional	26	$18.50	$23.41	$45.62
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $44.98 / $111.91	Professional	TC	$41.55	$44.98	$111.91
United Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $67.17 / $131.76	Professional		$31.04	$67.17	$131.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $21.11 / $37.86	Professional	26	$9.38	$21.11	$37.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.42 / $42.85 / $86.92	Professional	TC	$21.42	$42.85	$86.92