Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.06 / $13.86 / $16.76	Facility	26	$12.06	$13.86	$16.76
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.60 / $36.33 / $44.82	Facility	TC	$31.60	$36.33	$44.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $31.43 / $74.64	Professional		$25.17	$31.43	$74.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $9.53 / $30.76	Professional	26	$7.23	$9.53	$30.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $22.52 / $41.33	Professional	TC	$17.67	$22.52	$41.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $62.79 / $173.46	Professional		$27.94	$62.79	$173.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $17.97 / $52.20	Professional	26	$7.78	$17.97	$52.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $43.76 / $119.26	Professional	TC	$19.47	$43.76	$119.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.73 / $24.22 / $32.19	Facility	26	$20.73	$24.22	$32.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $58.57 / $68.45 / $90.97	Facility	TC	$58.57	$68.45	$90.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.47 / $102.49 / $116.46	Professional		$31.47	$102.49	$116.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $28.23 / $32.08	Professional	26	$9.52	$28.23	$32.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.95 / $74.26 / $84.39	Professional	TC	$21.95	$74.26	$84.39
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 $98.42 / $98.42 / $98.42	Facility	TC	$98.42	$98.42	$98.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $69.83 / $187.12	Professional		$30.49	$69.83	$187.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $20.82 / $51.02	Professional	26	$9.10	$20.82	$51.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $49.34 / $136.11	Professional	TC	$21.03	$49.34	$136.11
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 $36.96 / $70.20 / $119.42	Professional		$36.96	$70.20	$119.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $19.18 / $70.00 / $70.00	Facility	26	$19.18	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $50.45 / $98.42 / $98.42	Facility	TC	$50.45	$98.42	$98.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.16 / $139.65 / $187.12	Professional		$43.16	$139.65	$187.12
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $41.45 / $51.02	Professional	26	$12.52	$41.45	$51.02
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.28 / $98.20 / $136.11	Professional	TC	$31.28	$98.20	$136.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $182.59 / $182.59	Professional		$54.01	$182.59	$182.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.70 / $18.47 / $37.95	Professional	26	$15.70	$18.47	$37.95
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.32 / $41.55 / $95.71	Professional	TC	$35.32	$41.55	$95.71
United Facility/Professional Professional Modifier Low / Median / High Price $29.91 / $69.83 / $122.40	Professional		$29.91	$69.83	$122.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $18.98 / $36.33	Professional	26	$9.03	$18.98	$36.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $49.10 / $85.33	Professional	TC	$20.99	$49.10	$85.33