Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $30.20 / $44.67	Facility	26	$25.70	$30.20	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $181.97	Professional		$58.88	$85.11	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $22.91 / $57.54	Professional	26	$14.13	$22.91	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $60.26 / $123.03	Professional	TC	$44.67	$60.26	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $407.38	Professional		$75.86	$114.82	$407.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $26.92 / $91.20	Professional	26	$16.98	$26.92	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $93.33 / $309.03	Professional	TC	$57.54	$93.33	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $52.48 / $83.18	Facility	26	$44.67	$52.48	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $169.82 / $323.59	Professional		$70.79	$169.82	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $36.31 / $70.79	Professional	26	$17.78	$36.31	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $131.83 / $251.19	Professional	TC	$54.95	$131.83	$251.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $223.87	Professional		$147.91	$177.83	$223.87
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $38.02 / $47.86	Professional	26	$31.62	$38.02	$47.86
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $138.04 / $177.83	Professional	TC	$114.82	$138.04	$177.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $131.83 / $512.86	Professional		$72.44	$131.83	$512.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $33.11 / $109.65	Professional	26	$18.62	$33.11	$109.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $95.50 / $398.11	Professional	TC	$56.23	$95.50	$398.11
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 $95.50 / $186.21 / $281.84	Professional		$95.50	$186.21	$281.84
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $109.65 / $109.65	Facility	26	$39.81	$109.65	$109.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $380.19 / $512.86	Professional		$81.28	$380.19	$512.86
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $89.13 / $109.65	Professional	26	$20.89	$89.13	$109.65
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $288.40 / $398.11	Professional	TC	$61.66	$288.40	$398.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $501.19	Professional		$131.83	$204.17	$501.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.90 / $61.66	Professional	26	$33.11	$38.90	$61.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $107.15 / $223.87	Professional	TC	$91.20	$107.15	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $269.15	Professional		$72.44	$112.20	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $26.92 / $60.26	Professional	26	$17.78	$26.92	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $85.11 / $199.53	Professional	TC	$54.95	$85.11	$199.53