Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $29.00 / $29.00	Facility	26	$20.89	$29.00	$29.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.38 / $59.27 / $234.00	Professional		$38.38	$59.27	$234.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $17.17 / $38.67	Professional	26	$12.18	$17.17	$38.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $36.79 / $75.28	Professional	TC	$25.37	$36.79	$75.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.82 / $87.00 / $239.90	Professional		$40.82	$87.00	$239.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.47 / $30.63 / $86.74	Professional	26	$13.47	$30.63	$86.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.21 / $57.98 / $164.20	Professional	TC	$26.21	$57.98	$164.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.04 / $42.12 / $55.98	Facility	26	$36.04	$42.12	$55.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $154.75 / $175.85	Professional		$48.46	$154.75	$175.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.11 / $48.84 / $55.50	Professional	26	$15.11	$48.84	$55.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $105.92 / $120.36	Professional	TC	$33.97	$105.92	$120.36
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 $45.18 / $107.95 / $282.23	Professional		$45.18	$107.95	$282.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $36.84 / $100.72	Professional	26	$15.74	$36.84	$100.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.53 / $70.87 / $254.00	Professional	TC	$29.53	$70.87	$254.00
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 $85.15 / $127.57 / $187.12	Professional		$85.15	$127.57	$187.12
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 $68.12 / $207.60 / $282.23	Professional		$68.12	$207.60	$282.23
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $22.12 / $73.45 / $100.72	Professional	26	$22.12	$73.45	$100.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $134.15 / $254.00	Professional	TC	$46.00	$134.15	$254.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.98 / $250.74 / $275.72	Professional		$80.98	$250.74	$275.72
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.29 / $38.33 / $74.56	Professional	26	$30.29	$38.33	$74.56
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.70 / $74.26 / $157.00	Professional	TC	$50.70	$74.26	$157.00
United Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $93.95 / $181.96	Professional		$43.67	$93.95	$181.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $33.61 / $63.71	Professional	26	$15.16	$33.61	$63.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.24 / $59.04 / $117.73	Professional	TC	$28.24	$59.04	$117.73