Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.34 / $26.87 / $26.87	Facility	26	$19.34	$26.87	$26.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.07 / $62.24 / $536.74	Facility	TC	$45.07	$62.24	$536.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $64.41 / $261.00	Professional		$37.47	$64.41	$261.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $17.48 / $114.75	Professional	26	$11.52	$17.48	$114.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $32.11 / $59.86	Professional	TC	$23.17	$32.11	$59.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $84.95 / $242.70	Professional		$39.50	$84.95	$242.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $28.83 / $80.30	Professional	26	$12.48	$28.83	$80.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.21 / $57.98 / $164.20	Professional	TC	$26.21	$57.98	$164.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.34 / $38.96 / $51.78	Facility	26	$33.34	$38.96	$51.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $82.90 / $96.88 / $128.76	Facility	TC	$82.90	$96.88	$128.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.38 / $151.11 / $171.71	Professional		$45.38	$151.11	$171.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.55 / $45.19 / $51.35	Professional	26	$15.55	$45.19	$51.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.89 / $105.92 / $120.36	Professional	TC	$29.89	$105.92	$120.36
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 $136.22 / $136.22 / $136.22	Facility	TC	$136.22	$136.22	$136.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.04 / $100.30 / $277.95	Professional		$43.04	$100.30	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.15 / $34.54 / $81.06	Professional	26	$15.15	$34.54	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $66.44 / $196.89	Professional	TC	$28.59	$66.44	$196.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $74.33	Professional		$19.34	$33.89	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.30 / $100.97 / $166.38	Professional		$75.30	$100.97	$166.38
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $30.70 / $70.00 / $70.00	Facility	26	$30.70	$70.00	$70.00
Quartz Facility/Professional Facility Modifier TC Low / Median / High Price $71.95 / $136.22 / $136.22	Facility	TC	$71.95	$136.22	$136.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.65 / $200.60 / $277.95	Professional		$63.65	$200.60	$277.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $19.52 / $66.45 / $81.06	Professional	26	$19.52	$66.45	$81.06
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $44.61 / $134.15 / $196.89	Professional	TC	$44.61	$134.15	$196.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $269.26 / $269.26	Professional		$75.28	$269.26	$269.26
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.41 / $29.89 / $60.85	Professional	26	$25.41	$29.89	$60.85
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.69 / $53.75 / $134.76	Professional	TC	$45.69	$53.75	$134.76
United Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $94.21 / $175.83	Professional		$42.22	$94.21	$175.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $30.61 / $58.25	Professional	26	$14.24	$30.61	$58.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.26 / $57.02 / $111.18	Professional	TC	$28.26	$57.02	$111.18