Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.61 / $15.65 / $18.92	Facility	26	$13.61	$15.65	$18.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $42.72 / $180.33	Professional		$27.00	$42.72	$180.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.26 / $35.85	Professional	26	$8.13	$13.26	$35.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.44 / $16.32 / $61.61	Professional	52	$12.44	$16.32	$61.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $29.11 / $76.00	Professional	TC	$16.77	$29.11	$76.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $61.19 / $174.58	Professional		$27.56	$61.19	$174.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $20.28 / $56.50	Professional	26	$8.77	$20.28	$56.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $40.90 / $118.08	Professional	TC	$18.78	$40.90	$118.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.43 / $27.38 / $36.39	Facility	26	$23.43	$27.38	$36.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.59 / $101.42 / $115.25	Professional		$40.59	$101.42	$115.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $31.83 / $36.18	Professional	26	$11.70	$31.83	$36.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.47 / $69.59 / $79.09	Professional	TC	$28.47	$69.59	$79.09
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 $34.22 / $79.30 / $216.00	Professional		$34.22	$79.30	$216.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.66 / $25.22 / $79.26	Professional	26	$10.66	$25.22	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $56.02 / $205.00	Professional	TC	$23.56	$56.02	$205.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $37.91 / $74.33	Professional		$19.34	$37.91	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.55 / $84.72 / $136.59	Professional		$56.55	$84.72	$136.59
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 $48.22 / $150.10 / $216.00	Professional		$48.22	$150.10	$216.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $46.75 / $79.26	Professional	26	$14.75	$46.75	$79.26
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $103.35 / $205.00	Professional	TC	$32.22	$103.35	$205.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.17 / $180.73 / $180.73	Professional		$76.17	$180.73	$180.73
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.18 / $29.33 / $59.26	Professional	26	$23.18	$29.33	$59.26
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $60.69 / $170.15	Professional	TC	$52.99	$60.69	$170.15
United Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $73.65 / $157.94	Professional		$33.42	$73.65	$157.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.89 / $57.28 / $95.00	Professional	26	$13.89	$57.28	$95.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.76 / $49.54 / $91.94	Professional	TC	$22.76	$49.54	$91.94