Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $20.89 / $20.89	Facility	26	$18.20	$20.89	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $52.48 / $524.81	Professional		$22.91	$52.48	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.96 / $83.18	Professional	26	$8.91	$10.96	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $24.55 / $120.23	Professional	TC	$12.88	$24.55	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $43.65 / $134.90	Professional		$22.91	$43.65	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.13 / $48.98	Professional	26	$9.12	$14.13	$48.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $22.39 / $79.43	Professional	TC	$13.18	$22.39	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $19.50 / $32.36	Professional		$12.02	$19.50	$32.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $28.18 / $45.71	Facility	26	$24.55	$28.18	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $70.79 / $102.33	Professional		$23.99	$70.79	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $19.50 / $38.02	Professional	26	$10.00	$19.50	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $48.98 / $66.07	Professional	TC	$15.85	$48.98	$66.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $75.86	Professional		$46.77	$56.23	$75.86
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.89 / $28.18	Professional	26	$17.38	$20.89	$28.18
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $33.88 / $47.86	Professional	TC	$29.51	$33.88	$47.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	53	$53.70	$53.70	$53.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $79.43 / $758.58	Professional		$26.92	$79.43	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $23.99 / $131.83	Professional	26	$10.47	$23.99	$131.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $52.48 / $707.95	Professional	TC	$14.79	$52.48	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $64.57 / $269.15	Professional		$33.11	$64.57	$269.15
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $131.83 / $131.83	Facility	26	$21.88	$131.83	$131.83
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $11.75 / $67.61 / $67.61	Facility	53	$11.75	$67.61	$67.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $457.09 / $758.58	Professional		$23.44	$457.09	$758.58
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $48.98 / $131.83	Professional	26	$12.30	$48.98	$131.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $416.87 / $707.95	Professional	TC	$23.44	$416.87	$707.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $154.88 / $389.05	Professional		$50.12	$154.88	$389.05
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $169.82	Professional	26	$21.88	$26.92	$169.82
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $35.48 / $234.42	Professional	TC	$28.84	$35.48	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $51.29 / $190.55	Professional		$23.99	$51.29	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.49 / $35.48	Professional	26	$10.00	$15.49	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $28.18 / $158.49	Professional	TC	$13.49	$28.18	$158.49