Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.80 / $21.63 / $26.82	Facility	26	$18.80	$21.63	$26.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $87.97 / $403.75	Professional		$48.44	$87.97	$403.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $20.75 / $127.50	Professional	26	$11.92	$20.75	$127.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.13 / $58.05 / $162.49	Professional	TC	$36.13	$58.05	$162.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.59 / $105.12 / $304.52	Professional		$49.59	$105.12	$304.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $28.04 / $78.11	Professional	26	$12.14	$28.04	$78.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.20 / $76.55 / $215.09	Professional	TC	$35.20	$76.55	$215.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.22 / $45.57 / $70.34	Professional		$14.22	$45.57	$70.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.44 / $37.90 / $50.38	Facility	26	$32.44	$37.90	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.74 / $182.72 / $207.64	Professional		$57.74	$182.72	$207.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.46 / $43.98 / $49.98	Professional	26	$17.46	$43.98	$49.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.86 / $138.74 / $157.66	Professional	TC	$39.86	$138.74	$157.66
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.00 / $110.00 / $110.00	Facility	26	$110.00	$110.00	$110.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.27 / $122.06 / $330.09	Professional		$52.27	$122.06	$330.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $35.01 / $120.54	Professional	26	$14.98	$35.01	$120.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.06 / $88.97 / $292.00	Professional	TC	$37.06	$88.97	$292.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.32 / $77.04	Professional		$19.71	$46.32	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $151.91 / $230.21	Professional		$101.40	$151.91	$230.21
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $110.00 / $110.00	Facility	26	$100.00	$110.00	$110.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $86.89 / $233.00 / $330.09	Professional		$86.89	$233.00	$330.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $64.59 / $120.54	Professional	26	$20.38	$64.59	$120.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $58.44 / $169.65 / $292.00	Professional	TC	$58.44	$169.65	$292.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.14 / $289.42 / $325.58	Professional		$105.14	$289.42	$325.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $43.79 / $86.42	Professional	26	$34.61	$43.79	$86.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.53 / $81.93 / $190.81	Professional	TC	$70.53	$81.93	$190.81
United Facility/Professional Professional Modifier Low / Median / High Price $49.54 / $110.43 / $204.22	Professional		$49.54	$110.43	$204.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.55 / $29.76 / $56.62	Professional	26	$14.55	$29.76	$56.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.33 / $79.09 / $147.60	Professional	TC	$36.33	$79.09	$147.60