Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.04 / $12.69 / $15.35	Facility	26	$11.04	$12.69	$15.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.12 / $29.50 / $165.02	Facility	TC	$21.12	$29.50	$165.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $32.15 / $208.25	Professional		$20.92	$32.15	$208.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.59 / $11.04 / $52.25	Professional	26	$6.59	$11.04	$52.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.24 / $40.24 / $40.24	Professional	50	$40.24	$40.24	$40.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.18 / $18.44 / $34.35	Professional	TC	$12.18	$18.44	$34.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.75 / $46.26 / $130.93	Professional		$20.75	$46.26	$130.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $16.45 / $45.82	Professional	26	$7.12	$16.45	$45.82
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $31.12 / $72.54 / $196.39	Professional	50	$31.12	$72.54	$196.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.63 / $29.81 / $85.12	Professional	TC	$13.63	$29.81	$85.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.16 / $17.16 / $29.22	Professional		$8.16	$17.16	$29.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.92 / $22.11 / $29.39	Facility	26	$18.92	$22.11	$29.39
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $38.75 / $45.28 / $60.18	Facility	TC	$38.75	$45.28	$60.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $75.44 / $85.73	Professional		$28.54	$75.44	$85.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $25.80 / $29.31	Professional	26	$8.44	$25.80	$29.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $49.64 / $56.41	Professional	TC	$19.20	$49.64	$56.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $148.00	Facility	26	$100.00	$100.00	$148.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $213.30 / $395.56	Facility	TC	$100.00	$213.30	$395.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.22 / $53.11 / $172.00	Professional		$23.22	$53.11	$172.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $19.72 / $72.64	Professional	26	$8.64	$19.72	$72.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.58 / $34.65 / $148.00	Professional	TC	$14.58	$34.65	$148.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $50.00 / $74.12	Professional		$22.07	$50.00	$74.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $63.30 / $98.03	Professional		$42.25	$63.30	$98.03
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $101.85 / $172.00	Professional		$35.88	$101.85	$172.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $37.90 / $72.64	Professional	26	$11.96	$37.90	$72.64
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $63.95 / $148.00	Professional	TC	$23.00	$63.95	$148.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $49.30 / $134.46 / $134.46	Professional		$49.30	$134.46	$134.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.67 / $22.36 / $41.70	Professional	26	$17.67	$22.36	$41.70
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.63 / $40.02 / $93.12	Professional	TC	$31.63	$40.02	$93.12
United Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $46.92 / $89.38	Professional		$21.77	$46.92	$89.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $17.46 / $33.22	Professional	26	$7.94	$17.46	$33.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.10 / $30.84 / $56.12	Professional	TC	$14.10	$30.84	$56.12