Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.21 / $22.52 / $22.52	Facility	26	$16.21	$22.52	$22.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $60.79 / $261.00	Professional		$37.72	$60.79	$261.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $16.21 / $89.25	Professional	26	$10.01	$16.21	$89.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $44.57 / $75.28	Professional	TC	$26.01	$44.57	$75.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $86.36 / $249.14	Professional		$39.22	$86.36	$249.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $24.16 / $67.31	Professional	26	$10.46	$24.16	$67.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.76 / $60.38 / $174.90	Professional	TC	$28.76	$60.38	$174.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.95 / $34.86 / $54.99	Professional		$11.95	$34.86	$54.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.93 / $32.64 / $43.39	Facility	26	$27.93	$32.64	$43.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $142.65 / $162.10	Professional		$51.91	$142.65	$162.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $37.90 / $43.08	Professional	26	$12.86	$37.90	$43.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.06 / $104.74 / $119.03	Professional	TC	$39.06	$104.74	$119.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $340.00	Facility	26	$100.00	$100.00	$340.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.51 / $100.30 / $262.94	Professional		$43.51	$100.30	$262.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $29.43 / $117.24	Professional	26	$12.70	$29.43	$117.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $72.70 / $201.73	Professional	TC	$32.04	$72.70	$201.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $40.15 / $77.04	Professional		$19.34	$40.15	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.30 / $118.80 / $172.48	Professional		$79.30	$118.80	$172.48
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 $66.09 / $189.85 / $262.94	Professional		$66.09	$189.85	$262.94
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $55.70 / $117.24	Professional	26	$17.55	$55.70	$117.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.02 / $134.15 / $201.73	Professional	TC	$48.02	$134.15	$201.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $86.92 / $240.84 / $254.19	Professional		$86.92	$240.84	$254.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $31.35 / $65.05	Professional	26	$24.78	$31.35	$65.05
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.14 / $75.86 / $175.77	Professional	TC	$62.14	$75.86	$175.77
United Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $89.16 / $180.03	Professional		$42.23	$89.16	$180.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $25.51 / $48.82	Professional	26	$11.81	$25.51	$48.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.33 / $64.15 / $129.24	Professional	TC	$29.33	$64.15	$129.24