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 Facility Modifier TC Low / Median / High Price $35.59 / $50.40 / $202.98	Facility	TC	$35.59	$50.40	$202.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.55 / $49.20 / $216.75	Professional		$28.55	$49.20	$216.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $13.61 / $53.86	Professional	26	$8.46	$13.61	$53.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $26.03 / $45.97	Professional	TC	$18.32	$26.03	$45.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $68.39 / $187.01	Professional		$30.44	$68.39	$187.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $20.28 / $58.91	Professional	26	$8.77	$20.28	$58.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $48.16 / $130.41	Professional	TC	$21.58	$48.16	$130.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.03 / $29.09 / $44.99	Professional		$10.03	$29.09	$44.99
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 Facility Modifier TC Low / Median / High Price $65.78 / $76.87 / $102.17	Facility	TC	$65.78	$76.87	$102.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.07 / $115.48 / $131.22	Professional		$34.07	$115.48	$131.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $31.83 / $36.18	Professional	26	$10.68	$31.83	$36.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $83.66 / $95.06	Professional	TC	$23.56	$83.66	$95.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $110.49 / $216.22 / $550.72	Facility	TC	$110.49	$216.22	$550.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $76.26 / $208.77	Professional		$32.52	$76.26	$208.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.66 / $24.31 / $57.45	Professional	26	$10.66	$24.31	$57.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $52.37 / $151.32	Professional	TC	$22.50	$52.37	$151.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.09 / $74.33	Professional		$19.34	$33.09	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $78.88 / $128.65	Professional		$38.33	$78.88	$128.65
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $70.00 / $70.00	Facility	26	$21.63	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $56.83 / $110.49 / $110.49	Facility	TC	$56.83	$110.49	$110.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.64 / $151.80 / $208.77	Professional		$48.64	$151.80	$208.77
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $46.75 / $57.45	Professional	26	$14.02	$46.75	$57.45
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.22 / $105.05 / $151.32	Professional	TC	$35.22	$105.05	$151.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.51 / $205.79 / $205.79	Professional		$57.51	$205.79	$205.79
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $20.82 / $42.80	Professional	26	$17.70	$20.82	$42.80
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.61 / $43.07 / $103.55	Professional	TC	$36.61	$43.07	$103.55
United Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $61.03 / $133.05	Professional		$32.11	$61.03	$133.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $21.54 / $40.98	Professional	26	$10.02	$21.54	$40.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $47.13 / $92.07	Professional	TC	$22.13	$47.13	$92.07