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 / $22.91	Facility	26	$12.88	$15.49	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $50.12 / $263.03	Facility	TC	$34.67	$50.12	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $37.15 / $117.49	Professional		$14.79	$37.15	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $38.02	Professional	26	$7.94	$12.88	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $53.70	Professional	TC	$18.20	$25.12	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $165.96	Professional		$30.90	$48.98	$165.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $47.86	Professional	26	$8.71	$14.13	$47.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $35.48 / $120.23	Professional	TC	$21.88	$35.48	$120.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $28.84 / $42.66	Professional		$11.48	$28.84	$42.66
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 Facility Modifier TC Low / Median / High Price $66.07 / $77.62 / $123.03	Facility	TC	$66.07	$77.62	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $70.79 / $134.90	Professional		$30.90	$70.79	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $19.05 / $37.15	Professional	26	$9.55	$19.05	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $52.48 / $97.72	Professional	TC	$21.38	$52.48	$97.72
DeanCare Facility/Professional Facility Modifier TC Low / Median / High Price $229.09 / $281.84 / $371.54	Facility	TC	$229.09	$281.84	$371.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $72.44 / $97.72	Professional		$61.66	$72.44	$97.72
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.95 / $26.92	Professional	26	$16.60	$19.95	$26.92
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $51.29 / $67.61	Professional	TC	$44.67	$51.29	$67.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $109.65 / $512.86 / $549.54	Facility	TC	$109.65	$512.86	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $208.93	Professional		$30.90	$54.95	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.20 / $57.54	Professional	26	$9.77	$18.20	$57.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $36.31 / $151.36	Professional	TC	$21.38	$36.31	$151.36
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 $38.02 / $79.43 / $117.49	Professional		$38.02	$79.43	$117.49
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $70.79 / $70.79	Facility	26	$20.89	$70.79	$70.79
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $151.36 / $151.36	Facility	TC	$56.23	$151.36	$151.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $151.36 / $208.93	Professional		$35.48	$151.36	$208.93
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $46.77 / $57.54	Professional	26	$11.22	$46.77	$57.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $104.71 / $151.36	Professional	TC	$23.99	$104.71	$151.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $204.17	Professional		$57.54	$83.18	$204.17
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $20.89 / $26.30	Professional	26	$17.78	$20.89	$26.30
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $87.10	Professional	TC	$36.31	$42.66	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $109.65	Professional		$30.20	$45.71	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.13 / $31.62	Professional	26	$9.55	$14.13	$31.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $75.86	Professional	TC	$20.89	$31.62	$75.86