Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.60 / $31.41 / $31.41	Facility	26	$22.60	$31.41	$31.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.48 / $91.68 / $342.18	Professional		$53.48	$91.68	$342.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $22.60 / $209.00	Professional	26	$14.36	$22.60	$209.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.85 / $52.30 / $151.96	Professional	TC	$39.85	$52.30	$151.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.86 / $130.01 / $354.39	Professional		$57.86	$130.01	$354.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.58 / $33.45 / $97.15	Professional	26	$14.58	$33.45	$97.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.46 / $96.11 / $260.23	Professional	TC	$42.46	$96.11	$260.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $54.48 / $83.75	Professional		$16.70	$54.48	$83.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $46.33 / $61.58	Facility	26	$39.65	$46.33	$61.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.51 / $217.38 / $247.03	Professional		$65.51	$217.38	$247.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $52.84 / $60.05	Professional	26	$18.27	$52.84	$60.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.47 / $164.54 / $186.98	Professional	TC	$46.47	$164.54	$186.98
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 Professional Modifier Low / Median / High Price $62.32 / $148.12 / $395.03	Professional		$62.32	$148.12	$395.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.94 / $41.00 / $93.99	Professional	26	$17.94	$41.00	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.13 / $103.52 / $301.02	Professional	TC	$44.13	$103.52	$301.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $56.21 / $123.82	Professional		$25.04	$56.21	$123.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.34 / $146.72 / $242.72	Professional		$77.34	$146.72	$242.72
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $35.90 / $70.00 / $70.00	Facility	26	$35.90	$70.00	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.56 / $284.85 / $395.03	Professional		$91.56	$284.85	$395.03
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $78.80 / $93.99	Professional	26	$23.52	$78.80	$93.99
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $69.30 / $206.10 / $301.02	Professional	TC	$69.30	$206.10	$301.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.73 / $387.38 / $387.38	Professional		$109.73	$387.38	$387.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $35.36 / $70.59	Professional	26	$30.06	$35.36	$70.59
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.56 / $86.54 / $209.71	Professional	TC	$73.56	$86.54	$209.71
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $112.31 / $249.67	Professional		$60.26	$112.31	$249.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $36.29 / $69.06	Professional	26	$16.27	$36.29	$69.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $96.77 / $180.83	Professional	TC	$43.67	$96.77	$180.83