Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.49 / $10.91 / $13.19	Facility	26	$9.49	$10.91	$13.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.10 / $46.91 / $295.94	Facility	TC	$34.10	$46.91	$295.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.31 / $45.17 / $182.75	Professional		$25.31	$45.17	$182.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $10.36 / $58.65	Professional	26	$5.87	$10.36	$58.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $33.88 / $93.60	Professional	TC	$20.96	$33.88	$93.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $59.77 / $173.15	Professional		$27.70	$59.77	$173.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $14.14 / $39.38	Professional	26	$6.12	$14.14	$39.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.16 / $45.02 / $130.41	Professional	TC	$21.16	$45.02	$130.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.02 / $25.99 / $38.99	Professional		$7.02	$25.99	$38.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $18.95 / $25.19	Facility	26	$16.22	$18.95	$25.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $63.08 / $73.70 / $97.97	Facility	TC	$63.08	$73.70	$97.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.23 / $102.31 / $116.26	Professional		$29.23	$102.31	$116.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $22.19 / $25.21	Professional	26	$7.18	$22.19	$25.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.74 / $80.11 / $91.04	Professional	TC	$21.74	$80.11	$91.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $125.00	Facility	26	$100.00	$100.00	$125.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $102.96 / $201.80 / $301.25	Facility	TC	$102.96	$201.80	$301.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $67.09 / $187.25	Professional		$29.84	$67.09	$187.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $17.47 / $54.49	Professional	26	$7.44	$17.47	$54.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $52.83 / $146.99	Professional	TC	$22.39	$52.83	$146.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $73.76	Professional		$19.34	$33.89	$73.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.55 / $84.72 / $120.69	Professional		$56.55	$84.72	$120.69
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 Facility Modifier TC Low / Median / High Price $100.00 / $102.96 / $102.96	Facility	TC	$100.00	$102.96	$102.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.51 / $134.19 / $187.25	Professional		$43.51	$134.19	$187.25
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $32.60 / $54.49	Professional	26	$10.28	$32.60	$54.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $101.60 / $146.99	Professional	TC	$35.35	$101.60	$146.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.91 / $174.11 / $182.33	Professional		$59.91	$174.11	$182.33
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.55 / $18.41 / $35.90	Professional	26	$14.55	$18.41	$35.90
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $45.36 / $138.21	Professional	TC	$39.45	$45.36	$138.21
United Facility/Professional Professional Modifier Low / Median / High Price $28.55 / $61.49 / $117.63	Professional		$28.55	$61.49	$117.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $15.02 / $28.61	Professional	26	$6.99	$15.02	$28.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $47.72 / $108.98	Professional	TC	$21.65	$47.72	$108.98