Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.80 / $21.63 / $26.12	Facility	26	$18.80	$21.63	$26.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $63.89 / $240.25	Professional		$37.15	$63.89	$240.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $18.80 / $74.80	Professional	26	$11.74	$18.80	$74.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.01 / $36.99 / $155.80	Professional	TC	$25.01	$36.99	$155.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.84 / $89.51 / $242.63	Professional		$39.84	$89.51	$242.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $28.04 / $81.45	Professional	26	$12.14	$28.04	$81.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.18 / $62.06 / $168.03	Professional	TC	$27.18	$62.06	$168.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.86 / $36.65 / $58.28	Professional		$13.86	$36.65	$58.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.44 / $37.90 / $50.38	Facility	26	$32.44	$37.90	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.62 / $149.90 / $170.34	Professional		$44.62	$149.90	$170.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $43.98 / $49.98	Professional	26	$15.17	$43.98	$49.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.83 / $105.92 / $120.36	Professional	TC	$29.83	$105.92	$120.36
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $100.25 / $273.64	Professional		$42.95	$100.25	$273.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $34.50 / $78.91	Professional	26	$14.98	$34.50	$78.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $66.44 / $194.73	Professional	TC	$28.59	$66.44	$194.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $37.91 / $74.33	Professional		$19.34	$37.91	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $101.76 / $164.78	Professional		$48.60	$101.76	$164.78
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $29.88 / $70.00 / $70.00	Facility	26	$29.88	$70.00	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.13 / $200.50 / $273.64	Professional		$63.13	$200.50	$273.64
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.02 / $66.34 / $78.91	Professional	26	$19.02	$66.34	$78.91
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $44.61 / $134.15 / $194.73	Professional	TC	$44.61	$134.15	$194.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.25 / $267.12 / $267.12	Professional		$75.25	$267.12	$267.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.74 / $29.10 / $59.19	Professional	26	$24.74	$29.10	$59.19
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.33 / $54.51 / $133.19	Professional	TC	$46.33	$54.51	$133.19
United Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $92.14 / $175.74	Professional		$42.22	$92.14	$175.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.22 / $30.85 / $58.16	Professional	26	$14.22	$30.85	$58.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $57.68 / $113.85	Professional	TC	$28.51	$57.68	$113.85