Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $95.50	Facility	26	$67.61	$67.61	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $239.88	Professional		$77.62	$120.23	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $46.77 / $204.17	Professional	26	$17.78	$46.77	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $67.61 / $173.78	Professional	TC	$41.69	$67.61	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $524.81	Professional		$85.11	$151.36	$524.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $43.65 / $204.17	Professional	26	$17.38	$43.65	$204.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $93.33 / $288.40	Professional	TC	$48.98	$93.33	$288.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $120.23	Professional		$54.95	$60.26	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $138.04 / $218.78	Facility	26	$117.49	$138.04	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $281.84 / $416.87	Professional		$97.72	$281.84	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $85.11 / $181.97	Professional	26	$20.89	$85.11	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $165.96 / $275.42	Professional	TC	$67.61	$165.96	$275.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $288.40	Professional		$173.78	$208.93	$288.40
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $97.72 / $134.90	Professional	26	$79.43	$97.72	$134.90
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $109.65 / $173.78	Professional	TC	$93.33	$109.65	$173.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $269.15 / $2,884.03	Professional		$117.49	$269.15	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $64.57 / $426.58	Professional	26	$21.38	$64.57	$426.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $173.78 / $2,818.38	Professional	TC	$67.61	$173.78	$2,818.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $151.36	Professional		$32.36	$33.11	$151.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $512.86	Professional		$125.89	$239.88	$512.86
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $288.40 / $288.40	Facility	26	$104.71	$288.40	$288.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $1,659.59 / $3,019.95	Professional		$138.04	$1,659.59	$3,019.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $234.42 / $426.58	Professional	26	$29.51	$234.42	$426.58
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $1,584.89 / $2,884.03	Professional	TC	$77.62	$1,584.89	$2,884.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $478.63 / $602.56	Professional		$165.96	$478.63	$602.56
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $47.86 / $117.49	Professional	26	$38.02	$47.86	$117.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $147.91 / $257.04	Professional	TC	$125.89	$147.91	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $512.86	Professional		$109.65	$177.83	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $56.23 / $141.25	Professional	26	$21.88	$56.23	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $112.20 / $371.54	Professional	TC	$60.26	$112.20	$371.54