Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.23 / $22.55 / $22.55	Facility	26	$16.23	$22.55	$22.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.24 / $58.82 / $302.39	Professional		$34.24	$58.82	$302.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.13 / $16.23 / $108.66	Professional	26	$9.13	$16.23	$108.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $38.97 / $127.89	Professional	TC	$24.52	$38.97	$127.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $77.12 / $213.97	Professional		$35.08	$77.12	$213.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $21.51 / $63.25	Professional	26	$9.94	$21.51	$63.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $55.61 / $155.12	Professional	TC	$25.14	$55.61	$155.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.98 / $34.26 / $53.24	Professional		$11.98	$34.26	$53.24
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 $39.00 / $138.01 / $156.83	Professional		$39.00	$138.01	$156.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $37.94 / $43.11	Professional	26	$10.77	$37.94	$43.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $100.07 / $113.71	Professional	TC	$28.23	$100.07	$113.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $169.00	Facility	26	$100.00	$100.00	$169.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $91.55 / $252.05	Professional		$39.22	$91.55	$252.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $28.72 / $97.41	Professional	26	$11.91	$28.72	$97.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.31 / $65.31 / $183.85	Professional	TC	$27.31	$65.31	$183.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $37.57 / $76.19	Professional		$19.34	$37.57	$76.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $114.91 / $153.69	Professional		$76.70	$114.91	$153.69
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 $60.54 / $183.10 / $252.05	Professional		$60.54	$183.10	$252.05
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.99 / $57.50 / $97.41	Professional	26	$15.99	$57.50	$97.41
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $125.60 / $183.85	Professional	TC	$42.66	$125.60	$183.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $222.71 / $245.92	Professional		$70.80	$222.71	$245.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.86 / $28.30 / $51.40	Professional	26	$20.86	$28.30	$51.40
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.94 / $57.83 / $145.72	Professional	TC	$49.94	$57.83	$145.72
United Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $84.36 / $160.49	Professional		$38.61	$84.36	$160.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $24.73 / $45.46	Professional	26	$11.91	$24.73	$45.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.46 / $54.79 / $102.54	Professional	TC	$26.46	$54.79	$102.54