Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.06 / $16.76 / $88.20	Facility	26	$12.06	$16.76	$88.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $48.15 / $209.00	Professional		$25.87	$48.15	$209.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $17.27 / $76.50	Professional	26	$7.48	$17.27	$76.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $248.86 / $248.86 / $319.91	Professional	50	$248.86	$248.86	$319.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $36.09 / $147.26	Professional	TC	$20.79	$36.09	$147.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.65 / $63.51 / $177.04	Professional		$28.65	$63.51	$177.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $17.97 / $50.06	Professional	26	$7.78	$17.97	$50.06
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.97 / $103.84 / $295.08	Professional	50	$42.97	$103.84	$295.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $46.02 / $133.31	Professional	TC	$20.17	$46.02	$133.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $28.51 / $44.03	Professional		$8.90	$28.51	$44.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.73 / $24.22 / $32.19	Facility	26	$20.73	$24.22	$32.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $114.19 / $129.76	Professional		$32.47	$114.19	$129.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $28.23 / $32.08	Professional	26	$8.91	$28.23	$32.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.09 / $86.01 / $97.74	Professional	TC	$23.09	$86.01	$97.74
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 $32.11 / $77.98 / $206.66	Professional		$32.11	$77.98	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $22.47 / $79.26	Professional	26	$9.44	$22.47	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $54.22 / $161.00	Professional	TC	$23.10	$54.22	$161.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $74.33	Professional		$19.34	$33.89	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.70 / $95.43 / $124.54	Professional		$63.70	$95.43	$124.54
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 $50.47 / $149.90 / $206.66	Professional		$50.47	$149.90	$206.66
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $41.45 / $79.26	Professional	26	$13.07	$41.45	$79.26
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $108.45 / $161.00	Professional	TC	$36.22	$108.45	$161.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $182.79 / $203.46	Professional		$59.25	$182.79	$203.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.47 / $23.37 / $45.53	Professional	26	$18.47	$23.37	$45.53
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $48.20 / $119.43	Professional	TC	$40.78	$48.20	$119.43
United Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $69.06 / $131.55	Professional		$31.76	$69.06	$131.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $18.98 / $36.33	Professional	26	$8.88	$18.98	$36.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $49.42 / $95.06	Professional	TC	$23.10	$49.42	$95.06