Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.73 / $23.24 / $83.42	Facility	26	$16.73	$23.24	$83.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.59 / $286.55 / $484.72	Facility	TC	$38.59	$286.55	$484.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.21 / $55.32 / $322.20	Professional		$32.21	$55.32	$322.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $25.62 / $103.14	Professional	26	$10.43	$25.62	$103.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $38.59 / $161.27	Professional	TC	$21.82	$38.59	$161.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.39 / $72.97 / $208.20	Professional		$34.39	$72.97	$208.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $24.95 / $69.48	Professional	26	$10.80	$24.95	$69.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $50.87 / $140.58	Professional	TC	$22.99	$50.87	$140.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $31.08 / $50.10	Professional		$12.34	$31.08	$50.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.93 / $32.64 / $43.39	Facility	26	$27.93	$32.64	$43.39
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $71.19 / $83.19 / $110.57	Facility	TC	$71.19	$83.19	$110.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $128.62 / $146.16	Professional		$38.85	$128.62	$146.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $37.94 / $43.11	Professional	26	$13.18	$37.94	$43.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.68 / $90.68 / $103.05	Professional	TC	$25.68	$90.68	$103.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $249.00	Facility	26	$70.00	$70.00	$249.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $293.73 / $480.62	Facility	TC	$118.08	$293.73	$480.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.77 / $89.74 / $236.84	Professional		$37.77	$89.74	$236.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.11 / $30.38 / $70.37	Professional	26	$13.11	$30.38	$70.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.69 / $57.05 / $166.53	Professional	TC	$24.69	$57.05	$166.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.43 / $74.33	Professional		$19.34	$33.43	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $87.56 / $142.71	Professional		$64.34	$87.56	$142.71
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $25.78 / $70.00 / $70.00	Facility	26	$25.78	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $61.60 / $118.08 / $118.08	Facility	TC	$61.60	$118.08	$118.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $172.80 / $236.84	Professional		$54.18	$172.80	$236.84
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $57.50 / $70.37	Professional	26	$17.02	$57.50	$70.37
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $38.19 / $115.30 / $166.53	Professional	TC	$38.19	$115.30	$166.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $229.19 / $229.19	Professional		$64.53	$229.19	$229.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.74 / $25.58 / $52.68	Professional	26	$21.74	$25.58	$52.68
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.20 / $46.12 / $116.04	Professional	TC	$39.20	$46.12	$116.04
United Facility/Professional Professional Modifier Low / Median / High Price $36.45 / $79.14 / $151.44	Professional		$36.45	$79.14	$151.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $26.34 / $50.40	Professional	26	$11.91	$26.34	$50.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $52.80 / $97.66	Professional	TC	$24.54	$52.80	$97.66