Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.19 / $21.11 / $21.11	Facility	26	$15.19	$21.11	$21.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.92 / $51.78 / $283.50	Professional		$32.92	$51.78	$283.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $14.41 / $85.56	Professional	26	$9.52	$14.41	$85.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.39 / $34.99 / $75.38	Professional	TC	$21.39	$34.99	$75.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $71.76 / $207.88	Professional		$33.40	$71.76	$207.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $22.64 / $63.06	Professional	26	$9.80	$22.64	$63.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $48.26 / $133.31	Professional	TC	$22.36	$48.26	$133.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.21 / $29.50 / $46.89	Professional		$11.21	$29.50	$46.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.13 / $30.54 / $40.59	Facility	26	$26.13	$30.54	$40.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $121.48 / $138.05	Professional		$41.75	$121.48	$138.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $35.52 / $40.36	Professional	26	$12.86	$35.52	$40.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.90 / $86.01 / $97.74	Professional	TC	$28.90	$86.01	$97.74
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 $36.54 / $85.35 / $223.92	Professional		$36.54	$85.35	$223.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $28.04 / $92.47	Professional	26	$12.28	$28.04	$92.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.27 / $58.19 / $211.00	Professional	TC	$24.27	$58.19	$211.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $35.14 / $75.18	Professional		$19.34	$35.14	$75.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $101.28 / $184.08	Professional		$67.59	$101.28	$184.08
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 $56.29 / $164.05 / $223.92	Professional		$56.29	$164.05	$223.92
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $53.90 / $92.47	Professional	26	$16.45	$53.90	$92.47
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $37.96 / $110.20 / $211.00	Professional	TC	$37.96	$110.20	$211.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $207.03 / $216.52	Professional		$65.56	$207.03	$216.52
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $30.39 / $63.17	Professional	26	$24.02	$30.39	$63.17
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $57.12 / $143.84	Professional	TC	$41.55	$57.12	$143.84
United Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $77.05 / $146.28	Professional		$34.96	$77.05	$146.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $24.83 / $47.24	Professional	26	$11.55	$24.83	$47.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $50.44 / $96.67	Professional	TC	$23.46	$50.44	$96.67