Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $28.84	Facility	26	$19.95	$19.95	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $123.03	Professional		$33.88	$51.29	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.05 / $44.67	Professional	26	$10.96	$19.05	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $70.79	Professional	TC	$22.91	$31.62	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $218.78	Professional		$41.69	$66.07	$218.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.89 / $72.44	Professional	26	$13.49	$20.89	$72.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $144.54	Professional	TC	$26.92	$44.67	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $41.69 / $67.61	Facility	26	$36.31	$41.69	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $97.72 / $177.83	Professional		$43.65	$97.72	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $28.84 / $56.23	Professional	26	$14.13	$28.84	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $64.57 / $123.03	Professional	TC	$29.51	$64.57	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $131.83	Professional		$81.28	$95.50	$131.83
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.90 / $40.74	Professional	26	$25.12	$30.90	$40.74
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $66.07 / $91.20	Professional	TC	$54.95	$66.07	$91.20
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 $42.66 / $85.11 / $281.84	Professional		$42.66	$85.11	$281.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $28.84 / $100.00	Professional	26	$14.45	$28.84	$100.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $57.54 / $251.19	Professional	TC	$28.18	$57.54	$251.19
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 $56.23 / $109.65 / $186.21	Professional		$56.23	$109.65	$186.21
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 $51.29 / $208.93 / $281.84	Professional		$51.29	$208.93	$281.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $74.13 / $100.00	Professional	26	$17.38	$74.13	$100.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $134.90 / $251.19	Professional	TC	$35.48	$134.90	$251.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $199.53 / $275.42	Professional		$81.28	$199.53	$275.42
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $66.07	Professional	26	$30.20	$37.15	$66.07
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $61.66 / $134.90	Professional	TC	$51.29	$61.66	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $147.91	Professional		$40.74	$61.66	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.38 / $48.98	Professional	26	$14.13	$21.38	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $40.74 / $97.72	Professional	TC	$26.92	$40.74	$97.72