Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $13.80 / $17.38	Facility	26	$12.02	$13.80	$17.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $83.18	Professional		$25.70	$38.90	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $11.48 / $28.84	Professional	26	$6.76	$11.48	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.12 / $50.12	Professional	TC	$17.38	$25.12	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $169.82	Professional		$30.20	$48.98	$169.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $41.69	Professional	26	$7.76	$12.02	$41.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $37.15 / $120.23	Professional	TC	$21.38	$37.15	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $23.99 / $38.90	Facility	26	$20.89	$23.99	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $72.44 / $134.90	Professional		$31.62	$72.44	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $17.78 / $33.11	Professional	26	$8.71	$17.78	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $53.70 / $102.33	Professional	TC	$22.91	$53.70	$102.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $74.13 / $97.72	Professional		$61.66	$74.13	$97.72
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.62 / $23.99	Professional	26	$15.49	$18.62	$23.99
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $54.95 / $74.13	Professional	TC	$46.77	$54.95	$74.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $208.93	Professional		$30.90	$61.66	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $18.62 / $83.18	Professional	26	$9.12	$18.62	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $43.65 / $158.49	Professional	TC	$22.39	$43.65	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $70.79	Professional		$25.12	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $85.11 / $120.23	Professional		$43.65	$85.11	$120.23
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 $33.11 / $154.88 / $208.93	Professional		$33.11	$154.88	$208.93
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $43.65 / $83.18	Professional	26	$10.47	$43.65	$83.18
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $109.65 / $158.49	Professional	TC	$24.55	$109.65	$158.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $147.91 / $208.93	Professional		$60.26	$147.91	$208.93
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.44 / $43.65	Professional	26	$19.05	$23.44	$43.65
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $51.29 / $112.20	Professional	TC	$41.69	$51.29	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $109.65	Professional		$29.51	$45.71	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.18 / $28.18	Professional	26	$8.71	$13.18	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $77.62	Professional	TC	$21.38	$33.11	$77.62