Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $21.88 / $26.30	Facility	26	$18.20	$21.88	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $162.18	Professional		$33.88	$56.23	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $61.66	Professional	26	$10.96	$20.42	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $95.50	Professional	TC	$22.91	$32.36	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $64.57 / $213.80	Professional		$40.74	$64.57	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.95 / $66.07	Professional	26	$12.02	$19.95	$66.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $151.36	Professional	TC	$26.92	$44.67	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $36.31 / $53.70	Professional		$15.85	$36.31	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $38.02 / $60.26	Facility	26	$32.36	$38.02	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $91.20 / $173.78	Professional		$40.74	$91.20	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $26.92 / $51.29	Professional	26	$13.18	$26.92	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $66.07 / $123.03	Professional	TC	$27.54	$66.07	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $125.89	Professional		$79.43	$95.50	$125.89
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $27.54 / $37.15	Professional	26	$23.44	$27.54	$37.15
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $66.07 / $89.13	Professional	TC	$56.23	$66.07	$89.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $72.44 / $275.42	Professional		$40.74	$72.44	$275.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $25.70 / $79.43	Professional	26	$13.80	$25.70	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $46.77 / $194.98	Professional	TC	$26.92	$46.77	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $104.71 / $154.88	Professional		$48.98	$104.71	$154.88
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $79.43 / $79.43	Facility	26	$28.84	$79.43	$79.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $199.53 / $275.42	Professional		$45.71	$199.53	$275.42
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $66.07 / $79.43	Professional	26	$15.85	$66.07	$79.43
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $134.90 / $194.98	Professional	TC	$30.20	$134.90	$194.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $269.15	Professional		$75.86	$109.65	$269.15
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $28.84 / $37.15	Professional	26	$24.55	$28.84	$37.15
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $54.95 / $109.65	Professional	TC	$46.77	$54.95	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $144.54	Professional		$39.81	$60.26	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.42 / $43.65	Professional	26	$13.49	$20.42	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $39.81 / $97.72	Professional	TC	$26.30	$39.81	$97.72