Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.08 / $30.67 / $30.67	Facility	26	$22.08	$30.67	$30.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $92.60 / $501.50	Professional		$56.81	$92.60	$501.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.01 / $22.08 / $83.99	Professional	26	$14.01	$22.08	$83.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.05 / $69.00 / $103.68	Professional	TC	$41.05	$69.00	$103.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $129.22 / $375.96	Professional		$59.50	$129.22	$375.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $32.65 / $90.98	Professional	26	$14.24	$32.65	$90.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.53 / $92.36 / $277.20	Professional	TC	$42.53	$92.36	$277.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $54.09 / $82.82	Professional		$16.32	$54.09	$82.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.85 / $44.23 / $58.78	Facility	26	$37.85	$44.23	$58.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.89 / $215.00 / $244.31	Professional		$72.89	$215.00	$244.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $50.46 / $57.34	Professional	26	$20.32	$50.46	$57.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.24 / $164.54 / $186.98	Professional	TC	$53.24	$164.54	$186.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $126.00 / $126.00	Facility	26	$126.00	$126.00	$126.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.31 / $151.37 / $399.42	Professional		$65.31	$151.37	$399.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $40.79 / $151.90	Professional	26	$17.38	$40.79	$151.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.67 / $114.30 / $307.58	Professional	TC	$46.67	$114.30	$307.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $57.26 / $124.03	Professional		$25.04	$57.26	$124.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.60 / $179.18 / $264.11	Professional		$119.60	$179.18	$264.11
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $126.00 / $126.00	Facility	26	$100.00	$126.00	$126.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.61 / $286.50 / $399.42	Professional		$99.61	$286.50	$399.42
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $75.25 / $151.90	Professional	26	$23.38	$75.25	$151.90
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $74.97 / $211.20 / $307.58	Professional	TC	$74.97	$211.20	$307.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $362.90 / $383.12	Professional		$133.38	$362.90	$383.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.17 / $45.77 / $91.33	Professional	26	$36.17	$45.77	$91.33
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.22 / $103.17 / $271.58	Professional	TC	$97.22	$103.17	$271.58
United Facility/Professional Professional Modifier Low / Median / High Price $63.62 / $132.00 / $251.12	Professional		$63.62	$132.00	$251.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $35.34 / $66.04	Professional	26	$16.39	$35.34	$66.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.47 / $91.64 / $185.16	Professional	TC	$46.47	$91.64	$185.16