Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.71 / $21.83 / $21.83	Facility	26	$15.71	$21.83	$21.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.89 / $46.87 / $110.69	Professional		$35.89	$46.87	$110.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $11.51 / $30.91	Professional	26	$9.36	$11.51	$30.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $32.84 / $67.87	Professional	TC	$26.52	$32.84	$67.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $81.48 / $224.79	Professional		$37.46	$81.48	$224.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $23.42 / $65.25	Professional	26	$10.14	$23.42	$65.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.21 / $59.30 / $167.84	Professional	TC	$26.21	$59.30	$167.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.03 / $31.59 / $41.99	Facility	26	$27.03	$31.59	$41.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $145.00 / $164.78	Professional		$42.70	$145.00	$164.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $36.72 / $41.74	Professional	26	$12.20	$36.72	$41.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.50 / $108.27 / $123.04	Professional	TC	$30.50	$108.27	$123.04
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 $41.88 / $96.57 / $267.27	Professional		$41.88	$96.57	$267.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $28.97 / $85.85	Professional	26	$12.29	$28.97	$85.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.30 / $70.64 / $244.00	Professional	TC	$29.30	$70.64	$244.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $36.36 / $77.04	Professional		$19.34	$36.36	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $118.29 / $154.82	Professional		$79.95	$118.29	$154.82
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 $63.08 / $191.55 / $267.27	Professional		$63.08	$191.55	$267.27
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $55.70 / $85.85	Professional	26	$17.02	$55.70	$85.85
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $45.60 / $135.85 / $244.00	Professional	TC	$45.60	$135.85	$244.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $236.26 / $258.39	Professional		$77.00	$236.26	$258.39
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $31.35 / $61.03	Professional	26	$24.78	$31.35	$61.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.22 / $62.87 / $151.36	Professional	TC	$52.22	$62.87	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $40.42 / $83.98 / $167.89	Professional		$40.42	$83.98	$167.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $25.66 / $48.82	Professional	26	$11.93	$25.66	$48.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $62.59 / $119.07	Professional	TC	$28.87	$62.59	$119.07