Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.60 / $31.41 / $31.64	Facility	26	$22.60	$31.41	$31.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.96 / $48.00 / $117.00	Professional		$18.96	$48.00	$117.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $22.60 / $85.00	Professional	26	$8.22	$22.60	$85.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $28.57 / $52.52	Professional	TC	$11.48	$28.57	$52.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.21 / $62.68 / $227.38	Professional		$19.21	$62.68	$227.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $26.67 / $81.94	Professional	26	$8.60	$26.67	$81.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.39 / $40.08 / $141.96	Professional	TC	$10.39	$40.08	$141.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $33.47 / $58.25	Professional		$16.70	$33.47	$58.25
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 $28.68 / $149.38 / $169.75	Professional		$28.68	$149.38	$169.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $52.84 / $60.05	Professional	26	$10.14	$52.84	$60.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $96.54 / $109.70	Professional	TC	$18.19	$96.54	$109.70
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 $29.47 / $89.23 / $738.38	Professional		$29.47	$89.23	$738.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $33.86 / $95.54	Professional	26	$13.96	$33.86	$95.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.12 / $52.45 / $724.28	Professional	TC	$16.12	$52.45	$724.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $71.18	Professional		$19.34	$33.89	$71.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $101.76 / $146.49	Professional		$72.23	$101.76	$146.49
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 $62.92 / $206.65 / $738.38	Professional		$62.92	$206.65	$738.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $77.65 / $95.54	Professional	26	$22.26	$77.65	$95.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $129.00 / $724.28	Professional	TC	$40.65	$129.00	$724.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $95.79 / $266.19	Professional		$35.61	$95.79	$266.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $22.06 / $43.64	Professional	26	$17.70	$22.06	$43.64
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $36.40 / $120.70	Professional	TC	$17.91	$36.40	$120.70
United Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $57.44 / $153.96	Professional		$32.04	$57.44	$153.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.58 / $24.65 / $57.85	Professional	26	$14.58	$24.65	$57.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.95 / $33.15 / $96.11	Professional	TC	$16.95	$33.15	$96.11