Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.60 / $25.98 / $31.41	Facility	26	$22.60	$25.98	$31.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.53 / $104.72 / $357.00	Professional		$60.53	$104.72	$357.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $28.33 / $136.57	Professional	26	$14.36	$28.33	$136.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.50 / $61.56 / $167.89	Professional	TC	$45.50	$61.56	$167.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.19 / $145.81 / $394.81	Professional		$64.19	$145.81	$394.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.58 / $33.45 / $97.83	Professional	26	$14.58	$33.45	$97.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.85 / $114.18 / $309.14	Professional	TC	$49.85	$114.18	$309.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $63.29 / $94.94	Professional		$16.70	$63.29	$94.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $46.33 / $61.58	Facility	26	$39.65	$46.33	$61.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.22 / $246.72 / $280.36	Professional		$72.22	$246.72	$280.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $52.84 / $60.05	Professional	26	$18.27	$52.84	$60.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.65 / $193.83 / $220.26	Professional	TC	$54.65	$193.83	$220.26
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 $70.01 / $163.18 / $453.03	Professional		$70.01	$163.18	$453.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.09 / $41.28 / $95.54	Professional	26	$18.09	$41.28	$95.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $120.83 / $357.49	Professional	TC	$51.97	$120.83	$357.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $65.00 / $138.97	Professional		$38.69	$65.00	$138.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.30 / $166.44 / $267.10	Professional		$88.30	$166.44	$267.10
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $35.90 / $70.00 / $70.00	Facility	26	$35.90	$70.00	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $324.80 / $453.03	Professional		$103.90	$324.80	$453.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $79.34 / $95.54	Professional	26	$23.52	$79.34	$95.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $81.64 / $245.45 / $357.49	Professional	TC	$81.64	$245.45	$357.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $120.71 / $439.58 / $439.58	Professional		$120.71	$439.58	$439.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $35.36 / $70.59	Professional	26	$30.06	$35.36	$70.59
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.93 / $98.74 / $248.76	Professional	TC	$83.93	$98.74	$248.76
United Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $143.72 / $275.43	Professional		$68.56	$143.72	$275.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $37.27 / $69.64	Professional	26	$17.32	$37.27	$69.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $112.42 / $203.04	Professional	TC	$51.97	$112.42	$203.04