Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.84 / $22.81 / $27.56	Facility	26	$19.84	$22.81	$27.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.70 / $79.88 / $388.55	Professional		$49.70	$79.88	$388.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.45 / $33.33 / $122.76	Professional	26	$13.45	$33.33	$122.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.54 / $58.29 / $249.40	Professional	TC	$34.54	$58.29	$249.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.77 / $105.35 / $292.44	Professional		$49.77	$105.35	$292.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $29.57 / $82.36	Professional	26	$12.80	$29.57	$82.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.89 / $76.16 / $222.36	Professional	TC	$33.89	$76.16	$222.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.60 / $47.50 / $73.06	Professional		$14.60	$47.50	$73.06
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 $56.52 / $188.65 / $214.38	Professional		$56.52	$188.65	$214.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.46 / $45.19 / $51.35	Professional	26	$17.46	$45.19	$51.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $143.41 / $162.97	Professional	TC	$39.84	$143.41	$162.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.00 / $110.00 / $250.00	Facility	26	$110.00	$110.00	$250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.10 / $127.88 / $343.08	Professional		$54.10	$127.88	$343.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.54 / $37.52 / $113.92	Professional	26	$15.54	$37.52	$113.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $90.81 / $259.85	Professional	TC	$38.15	$90.81	$259.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.32 / $77.04	Professional		$19.71	$46.32	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $157.76 / $218.26	Professional		$105.30	$157.76	$218.26
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $110.00 / $110.00	Facility	26	$100.00	$110.00	$110.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.70 / $243.40 / $343.08	Professional		$89.70	$243.40	$343.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $68.15 / $113.92	Professional	26	$20.94	$68.15	$113.92
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $60.41 / $175.37 / $259.85	Professional	TC	$60.41	$175.37	$259.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.51 / $301.24 / $336.12	Professional		$97.51	$301.24	$336.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $43.79 / $86.42	Professional	26	$34.61	$43.79	$86.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.90 / $88.54 / $187.04	Professional	TC	$62.90	$88.54	$187.04
United Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $115.31 / $213.34	Professional		$51.92	$115.31	$213.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.04 / $76.51 / $95.00	Professional	26	$17.04	$76.51	$95.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.18 / $75.91 / $153.61	Professional	TC	$37.18	$75.91	$153.61