Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $15.49 / $19.05	Facility	26	$12.88	$15.49	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $41.69 / $107.15	Professional		$23.99	$41.69	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $35.48	Professional	26	$7.94	$12.88	$35.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $54.95 / $158.49	Professional	52	$30.20	$54.95	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.99 / $48.98	Professional	TC	$15.14	$23.99	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $151.36	Professional		$27.54	$50.12	$151.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.45 / $47.86	Professional	26	$8.71	$14.45	$47.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $34.67 / $102.33	Professional	TC	$18.62	$34.67	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $27.54 / $43.65	Facility	26	$23.44	$27.54	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $69.18 / $117.49	Professional		$37.15	$69.18	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $20.89 / $37.15	Professional	26	$9.55	$20.89	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $48.98 / $81.28	Professional	TC	$25.12	$48.98	$81.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $91.20	Professional		$53.70	$63.10	$91.20
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.95 / $27.54	Professional	26	$16.60	$19.95	$27.54
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $43.65 / $63.10	Professional	TC	$36.31	$43.65	$63.10
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 $33.11 / $69.18 / $213.80	Professional		$33.11	$69.18	$213.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $20.89 / $79.43	Professional	26	$10.00	$20.89	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $47.86 / $204.17	Professional	TC	$22.39	$47.86	$204.17
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 $39.81 / $77.62 / $128.82	Professional		$39.81	$77.62	$128.82
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 $41.69 / $199.53 / $213.80	Professional		$41.69	$199.53	$213.80
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $51.29 / $79.43	Professional	26	$12.59	$51.29	$79.43
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $147.91 / $204.17	Professional	TC	$28.18	$147.91	$204.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $190.55	Professional		$75.86	$128.82	$190.55
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.18 / $42.66	Professional	26	$23.44	$28.18	$42.66
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $60.26 / $87.10	Professional	TC	$52.48	$60.26	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $51.29 / $112.20	Professional		$31.62	$51.29	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.14 / $33.11	Professional	26	$9.77	$15.14	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $35.48 / $77.62	Professional	TC	$21.88	$35.48	$77.62