Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $50.12 / $60.26	Facility	26	$42.66	$50.12	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $245.47	Professional		$77.62	$107.15	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $43.65 / $107.15	Professional	26	$22.91	$43.65	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $134.90	Professional	TC	$53.70	$72.44	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $512.86	Professional		$95.50	$147.91	$512.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $42.66 / $147.91	Professional	26	$27.54	$42.66	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $107.15 / $331.13	Professional	TC	$61.66	$107.15	$331.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $81.28 / $123.03	Professional		$36.31	$81.28	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $87.10 / $138.04	Facility	26	$74.13	$87.10	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $213.80 / $398.11	Professional		$87.10	$213.80	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $63.10 / $114.82	Professional	26	$25.70	$63.10	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $162.18 / $281.84	Professional	TC	$63.10	$162.18	$281.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $213.80 / $288.40	Professional		$177.83	$213.80	$288.40
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $58.88 / $79.43	Professional	26	$52.48	$58.88	$79.43
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $147.91 / $204.17	Professional	TC	$125.89	$147.91	$204.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $251.19	Facility	26	$128.82	$128.82	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $173.78 / $645.65	Professional		$89.13	$173.78	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $58.88 / $181.97	Professional	26	$26.92	$58.88	$181.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $125.89 / $467.74	Professional	TC	$63.10	$125.89	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $223.87 / $380.19	Professional		$123.03	$223.87	$380.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $181.97 / $181.97	Facility	26	$100.00	$181.97	$181.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $467.74 / $645.65	Professional		$104.71	$467.74	$645.65
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $147.91 / $181.97	Professional	26	$31.62	$147.91	$181.97
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $316.23 / $467.74	Professional	TC	$77.62	$316.23	$467.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $467.74 / $616.60	Professional		$190.55	$467.74	$616.60
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $125.89	Professional	26	$51.29	$63.10	$125.89
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $138.04 / $323.59	Professional	TC	$102.33	$138.04	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $309.03	Professional		$89.13	$134.90	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $42.66 / $100.00	Professional	26	$26.30	$42.66	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $208.93	Professional	TC	$63.10	$93.33	$208.93