Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.13 / $32.13 / $32.13	Facility	26	$23.13	$32.13	$32.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.64 / $70.84 / $278.00	Professional		$43.64	$70.84	$278.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $23.13 / $119.00	Professional	26	$13.80	$23.13	$119.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.03 / $40.00 / $68.45	Professional	TC	$30.03	$40.00	$68.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $98.50 / $275.31	Professional		$45.92	$98.50	$275.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $34.22 / $95.36	Professional	26	$14.92	$34.22	$95.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $66.68 / $189.65	Professional	TC	$30.14	$66.68	$189.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $41.43 / $67.68	Professional		$17.09	$41.43	$67.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $46.33 / $61.58	Facility	26	$39.65	$46.33	$61.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.03 / $175.25 / $199.15	Professional		$52.03	$175.25	$199.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $52.92 / $60.14	Professional	26	$17.78	$52.92	$60.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.99 / $122.33 / $139.01	Professional	TC	$33.99	$122.33	$139.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $117.36 / $321.19	Professional		$51.98	$117.36	$321.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.94 / $41.02 / $128.79	Professional	26	$17.94	$41.02	$128.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $33.64 / $77.75 / $254.00	Professional	TC	$33.64	$77.75	$254.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $45.67 / $77.04	Professional		$19.71	$45.67	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $146.07 / $196.98	Professional		$97.50	$146.07	$196.98
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 $80.48 / $233.60 / $321.19	Professional		$80.48	$233.60	$321.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $78.84 / $128.79	Professional	26	$24.51	$78.84	$128.79
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $53.15 / $154.69 / $254.00	Professional	TC	$53.15	$154.69	$254.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.02 / $284.32 / $312.25	Professional		$96.02	$284.32	$312.25
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $44.80 / $86.24	Professional	26	$35.40	$44.80	$86.24
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.61 / $76.69 / $190.81	Professional	TC	$60.61	$76.69	$190.81
United Facility/Professional Professional Modifier Low / Median / High Price $49.08 / $108.98 / $197.03	Professional		$49.08	$108.98	$197.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $38.88 / $72.44	Professional	26	$17.19	$38.88	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.57 / $70.88 / $128.26	Professional	TC	$32.57	$70.88	$128.26