Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.34 / $22.24 / $26.87	Facility	26	$19.34	$22.24	$26.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.63 / $63.41 / $304.20	Professional		$35.63	$63.41	$304.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $19.55 / $126.72	Professional	26	$11.94	$19.55	$126.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.38 / $42.72 / $149.00	Professional	TC	$25.38	$42.72	$149.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $83.63 / $230.65	Professional		$38.79	$83.63	$230.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $28.83 / $80.30	Professional	26	$12.48	$28.83	$80.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $56.41 / $160.57	Professional	TC	$25.10	$56.41	$160.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.24 / $35.06 / $56.97	Professional		$14.24	$35.06	$56.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.34 / $38.96 / $51.78	Facility	26	$33.34	$38.96	$51.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.78 / $148.79 / $169.08	Professional		$43.78	$148.79	$169.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $45.19 / $51.35	Professional	26	$14.78	$45.19	$51.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.99 / $103.57 / $117.69	Professional	TC	$28.99	$103.57	$117.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $250.00	Facility	26	$100.00	$100.00	$250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $102.57 / $271.47	Professional		$43.55	$102.57	$271.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.15 / $36.02 / $94.11	Professional	26	$15.15	$36.02	$94.11
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.00 / $67.73 / $227.00	Professional	TC	$28.00	$67.73	$227.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $43.33 / $77.04	Professional		$19.34	$43.33	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $122.70 / $179.81	Professional		$81.90	$122.70	$179.81
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 $65.89 / $197.15 / $271.47	Professional		$65.89	$197.15	$271.47
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $66.45 / $94.11	Professional	26	$20.94	$66.45	$94.11
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $44.33 / $130.75 / $227.00	Professional	TC	$44.33	$130.75	$227.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.30 / $240.70 / $265.12	Professional		$78.30	$240.70	$265.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $37.82 / $72.70	Professional	26	$29.89	$37.82	$72.70
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.41 / $65.69 / $151.36	Professional	TC	$48.41	$65.69	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $41.50 / $84.77 / $172.80	Professional		$41.50	$84.77	$172.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.44 / $81.42 / $102.22	Professional	26	$16.44	$81.42	$102.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $56.20 / $114.56	Professional	TC	$27.79	$56.20	$114.56