Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $57.54 / $57.54	Facility	26	$40.74	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $251.19	Professional		$81.28	$123.03	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $32.36 / $102.33	Professional	26	$21.88	$32.36	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $97.72 / $204.17	Professional	TC	$66.07	$97.72	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $616.60	Professional		$109.65	$194.98	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $41.69 / $144.54	Professional	26	$26.92	$41.69	$144.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $141.25 / $478.63	Professional	TC	$81.28	$141.25	$478.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $87.10 / $138.04	Facility	26	$74.13	$87.10	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $269.15 / $524.81	Professional		$112.20	$269.15	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $58.88 / $112.20	Professional	26	$28.84	$58.88	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $223.87 / $407.38	Professional	TC	$87.10	$223.87	$407.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $269.15 / $354.81	Professional		$229.09	$269.15	$354.81
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.66 / $75.86	Professional	26	$50.12	$61.66	$75.86
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $213.80 / $275.42	Professional	TC	$177.83	$213.80	$275.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $223.87 / $870.96	Professional		$114.82	$223.87	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $57.54 / $199.53	Professional	26	$29.51	$57.54	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $169.82 / $691.83	Professional	TC	$85.11	$169.82	$691.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $141.25	Professional		$32.36	$33.11	$141.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $323.59 / $446.68	Professional		$173.78	$323.59	$446.68
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $177.83 / $177.83	Facility	26	$100.00	$177.83	$177.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $588.84 / $870.96	Professional		$138.04	$588.84	$870.96
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $144.54 / $199.53	Professional	26	$34.67	$144.54	$199.53
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $446.68 / $691.83	Professional	TC	$107.15	$446.68	$691.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $602.56 / $812.83	Professional		$218.78	$602.56	$812.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $77.62 / $131.83	Professional	26	$63.10	$77.62	$131.83
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $181.97 / $446.68	Professional	TC	$154.88	$181.97	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $398.11	Professional		$112.20	$173.78	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $43.65 / $97.72	Professional	26	$28.84	$43.65	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $128.82 / $295.12	Professional	TC	$85.11	$128.82	$295.12