Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $22.39 / $27.54	Facility	26	$15.85	$22.39	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $158.49	Professional		$33.88	$57.54	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.38 / $41.69	Professional	26	$8.91	$17.38	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $72.44	Professional	TC	$23.99	$36.31	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $208.93	Professional		$38.90	$60.26	$208.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.22 / $56.23	Professional	26	$10.47	$16.22	$56.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $151.36	Professional	TC	$28.84	$44.67	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $35.48 / $51.29	Professional		$13.49	$35.48	$51.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $32.36 / $52.48	Facility	26	$28.18	$32.36	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $97.72 / $165.96	Professional		$41.69	$97.72	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $22.91 / $43.65	Professional	26	$11.48	$22.91	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $72.44 / $120.23	Professional	TC	$30.20	$72.44	$120.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $89.13 / $123.03	Professional		$74.13	$89.13	$123.03
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $32.36	Professional	26	$19.95	$23.99	$32.36
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $66.07 / $91.20	Professional	TC	$54.95	$66.07	$91.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $338.84	Facility	26	$100.00	$100.00	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $263.03	Professional		$43.65	$83.18	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $25.70 / $117.49	Professional	26	$11.48	$25.70	$117.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $61.66 / $199.53	Professional	TC	$30.90	$61.66	$199.53
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 $54.95 / $107.15 / $173.78	Professional		$54.95	$107.15	$173.78
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $208.93 / $263.03	Professional		$54.95	$208.93	$263.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $56.23 / $117.49	Professional	26	$13.49	$56.23	$117.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $151.36 / $208.93	Professional	TC	$40.74	$151.36	$208.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $186.21 / $257.04	Professional		$87.10	$186.21	$257.04
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $51.29	Professional	26	$24.55	$30.20	$51.29
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $75.86 / $134.90	Professional	TC	$61.66	$75.86	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $141.25	Professional		$39.81	$60.26	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.98 / $38.02	Professional	26	$11.22	$16.98	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $43.65 / $100.00	Professional	TC	$28.18	$43.65	$100.00