Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.23 / $22.55 / $22.55	Facility	26	$16.23	$22.55	$22.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.24 / $58.82 / $318.75	Professional		$34.24	$58.82	$318.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $16.36 / $97.75	Professional	26	$9.98	$16.36	$97.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $42.10 / $163.38	Professional	TC	$24.75	$42.10	$163.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $77.56 / $215.78	Professional		$35.90	$77.56	$215.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $24.21 / $67.43	Professional	26	$10.48	$24.21	$67.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.24 / $55.61 / $156.93	Professional	TC	$25.24	$55.61	$156.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.98 / $34.26 / $53.24	Professional		$11.98	$34.26	$53.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.93 / $32.64 / $43.39	Facility	26	$27.93	$32.64	$43.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $139.18 / $158.16	Professional		$44.16	$139.18	$158.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $37.94 / $43.11	Professional	26	$12.20	$37.94	$43.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $101.24 / $115.05	Professional	TC	$32.36	$101.24	$115.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $198.00	Facility	26	$100.00	$100.00	$198.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $97.64 / $252.05	Professional		$41.15	$97.64	$252.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $29.91 / $92.47	Professional	26	$12.54	$29.91	$92.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.04 / $67.26 / $226.00	Professional	TC	$28.04	$67.26	$226.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $37.57 / $77.04	Professional		$19.34	$37.57	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $114.91 / $169.75	Professional		$76.70	$114.91	$169.75
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 $62.43 / $184.80 / $252.05	Professional		$62.43	$184.80	$252.05
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.54 / $57.50 / $92.47	Professional	26	$17.54	$57.50	$92.47
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $44.03 / $127.30 / $226.00	Professional	TC	$44.03	$127.30	$226.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $222.71 / $247.99	Professional		$73.95	$222.71	$247.99
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $30.39 / $59.15	Professional	26	$24.02	$30.39	$59.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.94 / $71.40 / $151.36	Professional	TC	$49.94	$71.40	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $84.64 / $161.97	Professional		$38.97	$84.64	$161.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $68.37 / $95.00	Professional	26	$16.73	$68.37	$95.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.82 / $58.14 / $110.52	Professional	TC	$26.82	$58.14	$110.52