Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $22.39 / $33.11	Facility	26	$13.80	$22.39	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $47.86 / $162.18	Professional		$18.20	$47.86	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $20.89 / $53.70	Professional	26	$11.75	$20.89	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $112.20	Professional	TC	$23.99	$39.81	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $63.10 / $208.93	Professional		$39.81	$63.10	$208.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.50 / $67.61	Professional	26	$12.59	$19.50	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $138.04	Professional	TC	$25.12	$43.65	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $35.48 / $53.70	Professional		$16.22	$35.48	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $38.90 / $61.66	Facility	26	$33.11	$38.90	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $95.50 / $173.78	Professional		$41.69	$95.50	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $27.54 / $52.48	Professional	26	$13.49	$27.54	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $63.10 / $120.23	Professional	TC	$27.54	$63.10	$120.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $125.89	Professional		$77.62	$93.33	$125.89
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.18 / $38.02	Professional	26	$23.44	$28.18	$38.02
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $64.57 / $89.13	Professional	TC	$53.70	$64.57	$89.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $251.19	Facility	26	$100.00	$100.00	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $89.13 / $269.15	Professional		$40.74	$89.13	$269.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $33.11 / $93.33	Professional	26	$13.80	$33.11	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $52.48 / $229.09	Professional	TC	$26.92	$52.48	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $107.15 / $162.18	Professional		$54.95	$107.15	$162.18
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 $45.71 / $194.98 / $269.15	Professional		$45.71	$194.98	$269.15
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $66.07 / $93.33	Professional	26	$16.22	$66.07	$93.33
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $131.83 / $229.09	Professional	TC	$30.20	$131.83	$229.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $190.55 / $263.03	Professional		$77.62	$190.55	$263.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $60.26	Professional	26	$30.20	$37.15	$60.26
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $131.83	Professional	TC	$47.86	$61.66	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $58.88 / $141.25	Professional		$39.81	$58.88	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.42 / $44.67	Professional	26	$13.49	$20.42	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $38.90 / $95.50	Professional	TC	$26.30	$38.90	$95.50