Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $30.20	Facility	26	$20.89	$20.89	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $85.11 / $173.78	Professional		$51.29	$85.11	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $24.55 / $66.07	Professional	26	$12.88	$24.55	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $52.48 / $104.71	Professional	TC	$37.15	$52.48	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $323.59	Professional		$60.26	$93.33	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $25.12 / $77.62	Professional	26	$13.80	$25.12	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $70.79 / $218.78	Professional	TC	$40.74	$70.79	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $57.54 / $79.43	Professional		$18.20	$57.54	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $44.67 / $70.79	Facility	26	$38.02	$44.67	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $147.91 / $257.04	Professional		$61.66	$147.91	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $35.48 / $58.88	Professional	26	$15.85	$35.48	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $102.33 / $194.98	Professional	TC	$45.71	$102.33	$194.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $186.21	Professional		$114.82	$138.04	$186.21
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $31.62 / $46.77	Professional	26	$26.30	$31.62	$46.77
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $104.71 / $141.25	Professional	TC	$87.10	$104.71	$141.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $117.49 / $398.11	Professional		$63.10	$117.49	$398.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $34.67 / $138.04	Professional	26	$17.38	$34.67	$138.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $87.10 / $354.81	Professional	TC	$44.67	$87.10	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $158.49 / $239.88	Professional		$81.28	$158.49	$239.88
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $125.89 / $125.89	Facility	26	$100.00	$125.89	$125.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $302.00 / $398.11	Professional		$70.79	$302.00	$398.11
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $85.11 / $138.04	Professional	26	$20.42	$85.11	$138.04
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $218.78 / $354.81	Professional	TC	$51.29	$218.78	$354.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $281.84 / $389.05	Professional		$120.23	$281.84	$389.05
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $48.98 / $67.61	Professional	26	$39.81	$48.98	$67.61
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $102.33 / $213.80	Professional	TC	$81.28	$102.33	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $208.93	Professional		$60.26	$87.10	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $24.55 / $54.95	Professional	26	$15.49	$24.55	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $64.57 / $154.88	Professional	TC	$44.67	$64.57	$154.88