Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $21.88 / $26.92	Facility	26	$13.80	$21.88	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $79.43 / $229.09	Professional		$44.67	$79.43	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $23.44 / $83.18	Professional	26	$11.75	$23.44	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $52.48 / $141.25	Professional	TC	$32.36	$52.48	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $263.03	Professional		$50.12	$77.62	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $21.38 / $67.61	Professional	26	$12.02	$21.38	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $56.23 / $186.21	Professional	TC	$35.48	$56.23	$186.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $46.77 / $66.07	Professional		$16.22	$46.77	$66.07
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 $52.48 / $123.03 / $213.80	Professional		$52.48	$123.03	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $30.90 / $51.29	Professional	26	$13.80	$30.90	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $85.11 / $162.18	Professional	TC	$36.31	$85.11	$162.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $154.88	Professional		$95.50	$114.82	$154.88
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.18 / $38.90	Professional	26	$23.44	$28.18	$38.90
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $83.18 / $109.65	Professional	TC	$72.44	$83.18	$109.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $100.00 / $331.13	Professional		$51.29	$100.00	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $32.36 / $120.23	Professional	26	$14.79	$32.36	$120.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $69.18 / $295.12	Professional	TC	$36.31	$69.18	$295.12
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 $69.18 / $134.90 / $229.09	Professional		$69.18	$134.90	$229.09
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $109.65 / $109.65	Facility	26	$100.00	$109.65	$109.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $331.13 / $331.13	Professional		$60.26	$331.13	$331.13
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $74.13 / $120.23	Professional	26	$18.62	$74.13	$120.23
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $169.82 / $295.12	Professional	TC	$41.69	$169.82	$295.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $229.09 / $323.59	Professional		$104.71	$229.09	$323.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $42.66 / $61.66	Professional	26	$34.67	$42.66	$61.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $81.28 / $173.78	Professional	TC	$70.79	$81.28	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $169.82	Professional		$48.98	$72.44	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.89 / $47.86	Professional	26	$13.49	$20.89	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $123.03	Professional	TC	$35.48	$51.29	$123.03