Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.41 / $25.77 / $30.92	Facility	26	$22.41	$25.77	$30.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $70.68 / $198.92	Professional		$37.39	$70.68	$198.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $21.62 / $86.40	Professional	26	$8.13	$21.62	$86.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.58 / $103.97	Professional	TC	$23.99	$41.58	$103.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.28 / $92.65 / $260.45	Professional		$41.28	$92.65	$260.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $27.56 / $79.94	Professional	26	$14.45	$27.56	$79.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.83 / $68.98 / $171.59	Professional	TC	$26.83	$68.98	$171.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.50 / $33.47 / $57.99	Professional		$16.50	$33.47	$57.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.85 / $44.23 / $58.78	Facility	26	$37.85	$44.23	$58.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.29 / $148.57 / $168.83	Professional		$61.29	$148.57	$168.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.92 / $50.86 / $57.80	Professional	26	$10.92	$50.86	$57.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.99 / $97.71 / $111.04	Professional	TC	$39.99	$97.71	$111.04
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 $48.07 / $108.57 / $475.98	Professional		$48.07	$108.57	$475.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $34.36 / $211.35	Professional	26	$14.44	$34.36	$211.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $86.27 / $429.40	Professional	TC	$30.14	$86.27	$429.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $46.32 / $85.00	Professional		$19.34	$46.32	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.85 / $125.62 / $245.01	Professional		$83.85	$125.62	$245.01
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 $70.65 / $295.82 / $475.98	Professional		$70.65	$295.82	$475.98
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $74.70 / $211.35	Professional	26	$21.42	$74.70	$211.35
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $46.46 / $267.92 / $429.40	Professional	TC	$46.46	$267.92	$429.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $264.72 / $264.72	Professional		$101.60	$264.72	$264.72
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.87 / $30.35 / $68.88	Professional	26	$18.87	$30.35	$68.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.73 / $104.68 / $245.28	Professional	TC	$82.73	$104.68	$245.28
United Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $100.15 / $186.51	Professional		$43.79	$100.15	$186.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $24.26 / $57.52	Professional	26	$12.03	$24.26	$57.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.65 / $67.81 / $158.41	Professional	TC	$27.65	$67.81	$158.41