Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $52.48 / $57.54	Facility	26	$25.70	$52.48	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $123.03 / $323.59	Professional		$61.66	$123.03	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $47.86 / $95.50	Professional	26	$26.30	$47.86	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $87.10 / $204.17	Professional	TC	$41.69	$87.10	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $575.44	Professional		$100.00	$154.88	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $41.69 / $154.88	Professional	26	$26.92	$41.69	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $112.20 / $416.87	Professional	TC	$72.44	$112.20	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $89.13 / $128.82	Professional		$34.67	$89.13	$128.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $85.11 / $134.90	Facility	26	$72.44	$85.11	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $245.47 / $416.87	Professional		$95.50	$245.47	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $58.88 / $112.20	Professional	26	$25.12	$58.88	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $186.21 / $302.00	Professional	TC	$70.79	$186.21	$302.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $302.00	Professional		$186.21	$223.87	$302.00
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $81.28	Professional	26	$50.12	$60.26	$81.28
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $162.18 / $223.87	Professional	TC	$138.04	$162.18	$223.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $660.69	Professional		$100.00	$186.21	$660.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $57.54 / $173.78	Professional	26	$29.51	$57.54	$173.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $128.82 / $489.78	Professional	TC	$70.79	$128.82	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $234.42 / $346.74	Professional		$117.49	$234.42	$346.74
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $251.19 / $251.19	Facility	26	$64.57	$251.19	$251.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $630.96 / $660.69	Professional		$104.71	$630.96	$660.69
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $173.78 / $173.78	Professional	26	$32.36	$173.78	$173.78
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $446.68 / $489.78	Professional	TC	$74.13	$446.68	$489.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $478.63 / $660.69	Professional		$295.12	$478.63	$660.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $95.50 / $131.83	Professional	26	$81.28	$95.50	$131.83
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $229.09 / $354.81	Professional	TC	$194.98	$229.09	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $371.54	Professional		$100.00	$158.49	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $44.67 / $102.33	Professional	26	$29.51	$44.67	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $263.03	Professional	TC	$70.79	$112.20	$263.03