Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.09 / $15.05 / $18.18	Facility	26	$13.09	$15.05	$18.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.42 / $38.92 / $156.85	Professional		$22.42	$38.92	$156.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.52 / $51.87	Professional	26	$7.95	$11.52	$51.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.00 / $22.12 / $41.59	Professional	TC	$13.00	$22.12	$41.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $50.79 / $146.19	Professional		$22.71	$50.79	$146.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $19.50 / $54.31	Professional	26	$8.44	$19.50	$54.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.06 / $80.67 / $220.99	Professional	50	$34.06	$80.67	$220.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.27 / $32.33 / $92.38	Professional	TC	$14.27	$32.33	$92.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.65 / $18.35 / $32.43	Professional		$9.65	$18.35	$32.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.53 / $26.33 / $34.99	Facility	26	$22.53	$26.33	$34.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $83.77 / $95.19	Professional		$32.10	$83.77	$95.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $30.62 / $34.79	Professional	26	$9.56	$30.62	$34.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $53.17 / $60.43	Professional	TC	$21.76	$53.17	$60.43
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 $29.61 / $69.12 / $203.00	Professional		$29.61	$69.12	$203.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $23.39 / $84.21	Professional	26	$10.25	$23.39	$84.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $46.44 / $165.00	Professional	TC	$19.36	$46.44	$165.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $70.00	Professional		$19.34	$33.89	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $70.11 / $137.31	Professional		$46.80	$70.11	$137.31
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 $39.84 / $132.85 / $203.00	Professional		$39.84	$132.85	$203.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.18 / $44.95 / $84.21	Professional	26	$14.18	$44.95	$84.21
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $24.63 / $87.90 / $165.00	Professional	TC	$24.63	$87.90	$165.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $149.26 / $149.26	Professional		$64.62	$149.26	$149.26
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.03 / $25.34 / $51.51	Professional	26	$20.03	$25.34	$51.51
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.60 / $51.59 / $130.69	Professional	TC	$44.60	$51.59	$130.69
United Facility/Professional Professional Modifier Low / Median / High Price $28.76 / $63.34 / $144.65	Professional		$28.76	$63.34	$144.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $21.11 / $39.40	Professional	26	$9.81	$21.11	$39.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $40.50 / $77.14	Professional	TC	$18.38	$40.50	$77.14