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 $32.36 / $57.54 / $151.36	Professional		$32.36	$57.54	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $18.20 / $42.66	Professional	26	$8.91	$18.20	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $91.20	Professional	TC	$21.88	$33.11	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $186.21	Professional		$35.48	$58.88	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $53.70	Professional	26	$10.00	$16.22	$53.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $42.66 / $141.25	Professional	TC	$25.12	$42.66	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $34.67 / $50.12	Professional		$13.80	$34.67	$50.12
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 $37.15 / $83.18 / $158.49	Professional		$37.15	$83.18	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $22.91 / $43.65	Professional	26	$10.00	$22.91	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $61.66 / $114.82	Professional	TC	$26.92	$61.66	$114.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $112.20	Professional		$72.44	$85.11	$112.20
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $30.90	Professional	26	$19.95	$23.99	$30.90
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $60.26 / $79.43	Professional	TC	$52.48	$60.26	$79.43
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $169.82	Facility	26	$100.00	$100.00	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $74.13 / $251.19	Professional		$36.31	$74.13	$251.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $22.91 / $97.72	Professional	26	$10.96	$22.91	$97.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $51.29 / $181.97	Professional	TC	$26.30	$51.29	$181.97
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 $50.12 / $97.72 / $141.25	Professional		$50.12	$97.72	$141.25
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 $39.81 / $181.97 / $251.19	Professional		$39.81	$181.97	$251.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $57.54 / $97.72	Professional	26	$11.75	$57.54	$97.72
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $125.89 / $181.97	Professional	TC	$28.18	$125.89	$181.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $177.83 / $245.47	Professional		$70.79	$177.83	$245.47
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $51.29	Professional	26	$20.89	$25.70	$51.29
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $54.95 / $125.89	Professional	TC	$50.12	$54.95	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $125.89	Professional		$35.48	$53.70	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.60 / $37.15	Professional	26	$10.23	$16.60	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $91.20	Professional	TC	$25.12	$37.15	$91.20