Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.56 / $17.46 / $17.46	Facility	26	$12.56	$17.46	$17.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $59.63 / $224.41	Professional		$34.11	$59.63	$224.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $11.66 / $72.20	Professional	26	$7.52	$11.66	$72.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.33 / $72.33 / $72.33	Professional	50	$72.33	$72.33	$72.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.97 / $33.54 / $80.31	Professional	TC	$23.97	$33.54	$80.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $78.75 / $218.61	Professional		$36.02	$78.75	$218.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $18.71 / $52.12	Professional	26	$8.10	$18.71	$52.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $54.24 / $131.58 / $365.88	Professional	50	$54.24	$131.58	$365.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.37 / $62.08 / $173.29	Professional	TC	$27.37	$62.08	$173.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.26 / $35.90 / $53.87	Professional		$9.26	$35.90	$53.87
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 Professional Modifier Low / Median / High Price $36.44 / $140.00 / $159.09	Professional		$36.44	$140.00	$159.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $28.23 / $32.08	Professional	26	$10.16	$28.23	$32.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.44 / $111.77 / $127.01	Professional	TC	$26.44	$111.77	$127.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $244.00	Facility	26	$100.00	$100.00	$244.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $92.93 / $260.95	Professional		$39.46	$92.93	$260.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.83 / $22.45 / $83.63	Professional	26	$9.83	$22.45	$83.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $71.34 / $207.72	Professional	TC	$30.32	$71.34	$207.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $35.08 / $77.04	Professional		$19.34	$35.08	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $116.86 / $155.09	Professional		$78.00	$116.86	$155.09
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.96 / $185.85 / $260.95	Professional		$58.96	$185.85	$260.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $43.15 / $83.63	Professional	26	$13.07	$43.15	$83.63
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $47.08 / $142.69 / $207.72	Professional	TC	$47.08	$142.69	$207.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.79 / $231.63 / $249.46	Professional		$76.79	$231.63	$249.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $24.33 / $53.38	Professional	26	$19.23	$24.33	$53.38
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.55 / $57.56 / $151.36	Professional	TC	$48.55	$57.56	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $71.12 / $160.79	Professional		$37.36	$71.12	$160.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.35 / $45.37 / $87.90	Professional	26	$14.35	$45.37	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.45 / $95.00 / $219.61	Professional	TC	$41.45	$95.00	$219.61