Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.20 / $25.12	Facility	26	$18.20	$18.20	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $120.23	Professional		$33.88	$53.70	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $19.05 / $41.69	Professional	26	$10.00	$19.05	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $64.57	Professional	TC	$22.91	$32.36	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.10 / $213.80	Professional		$38.90	$63.10	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.20 / $58.88	Professional	26	$11.48	$18.20	$58.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $151.36	Professional	TC	$28.18	$44.67	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $36.31 / $53.70	Professional		$15.49	$36.31	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $37.15 / $58.88	Facility	26	$31.62	$37.15	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $97.72 / $173.78	Professional		$40.74	$97.72	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $25.70 / $50.12	Professional	26	$11.48	$25.70	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $69.18 / $123.03	Professional	TC	$28.84	$69.18	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $125.89	Professional		$77.62	$93.33	$125.89
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.92 / $37.15	Professional	26	$22.39	$26.92	$37.15
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 $91.20 / $100.00 / $100.00	Facility	26	$91.20	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $269.15	Professional		$38.90	$77.62	$269.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $26.30 / $97.72	Professional	26	$12.30	$26.30	$97.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $54.95 / $208.93	Professional	TC	$28.18	$54.95	$208.93
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 $56.23 / $109.65 / $190.55	Professional		$56.23	$109.65	$190.55
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 $44.67 / $213.80 / $269.15	Professional		$44.67	$213.80	$269.15
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $63.10 / $97.72	Professional	26	$13.18	$63.10	$97.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $158.49 / $208.93	Professional	TC	$31.62	$158.49	$208.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $190.55 / $263.03	Professional		$81.28	$190.55	$263.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $29.51 / $57.54	Professional	26	$23.99	$29.51	$57.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $69.18 / $131.83	Professional	TC	$57.54	$69.18	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $58.88 / $141.25	Professional		$38.90	$58.88	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.62 / $40.74	Professional	26	$11.75	$18.62	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $41.69 / $97.72	Professional	TC	$28.18	$41.69	$97.72