Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $34.67 / $51.29	Facility	26	$30.20	$34.67	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $251.19	Professional		$74.13	$114.82	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $30.20 / $70.79	Professional	26	$16.98	$30.20	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $169.82	Professional	TC	$54.95	$75.86	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $478.63	Professional		$89.13	$147.91	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.90 / $104.71	Professional	26	$19.50	$30.90	$104.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $114.82 / $371.54	Professional	TC	$69.18	$114.82	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $61.66 / $97.72	Facility	26	$52.48	$61.66	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $208.93 / $398.11	Professional		$87.10	$208.93	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $42.66 / $81.28	Professional	26	$20.89	$42.66	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $165.96 / $323.59	Professional	TC	$66.07	$165.96	$323.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $275.42	Professional		$181.97	$218.78	$275.42
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $44.67 / $56.23	Professional	26	$36.31	$44.67	$56.23
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $169.82 / $218.78	Professional	TC	$144.54	$169.82	$218.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $630.96	Professional		$87.10	$151.36	$630.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $38.02 / $128.82	Professional	26	$21.38	$38.02	$128.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $114.82 / $512.86	Professional	TC	$67.61	$114.82	$512.86
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 $114.82 / $229.09 / $346.74	Professional		$114.82	$229.09	$346.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $128.82 / $128.82	Facility	26	$46.77	$128.82	$128.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $446.68 / $630.96	Professional		$100.00	$446.68	$630.96
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $102.33 / $128.82	Professional	26	$23.99	$102.33	$128.82
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $346.74 / $512.86	Professional	TC	$77.62	$346.74	$512.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $257.04 / $616.60	Professional		$154.88	$257.04	$616.60
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $72.44	Professional	26	$38.02	$44.67	$72.44
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $128.82 / $275.42	Professional	TC	$109.65	$128.82	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $316.23	Professional		$87.10	$131.83	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $31.62 / $70.79	Professional	26	$20.89	$31.62	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $102.33 / $239.88	Professional	TC	$66.07	$102.33	$239.88