Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.27 / $19.67 / $35.04	Facility	26	$18.27	$19.67	$35.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.76 / $73.36 / $337.00	Professional		$23.76	$73.36	$337.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $14.50 / $93.10	Professional	26	$8.85	$14.50	$93.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $27.90 / $92.72	Professional	TC	$15.41	$27.90	$92.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.09 / $54.89 / $141.47	Professional		$23.09	$54.89	$141.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $21.11 / $58.81	Professional	26	$9.14	$21.11	$58.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.95 / $30.38 / $84.23	Professional	TC	$13.95	$30.38	$84.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $19.55 / $34.79	Professional		$10.45	$19.55	$34.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.33 / $28.43 / $37.79	Facility	26	$24.33	$28.43	$37.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.38 / $87.44 / $109.18	Professional		$35.38	$87.44	$109.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $33.11 / $37.64	Professional	26	$11.70	$33.11	$37.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.20 / $54.32 / $66.48	Professional	TC	$23.20	$54.32	$66.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $132.00 / $132.00 / $132.00	Facility	26	$132.00	$132.00	$132.00
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $53.18 / $53.18 / $53.18	Facility	53	$53.18	$53.18	$53.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $79.93 / $761.56	Professional		$26.62	$79.93	$761.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $26.37 / $132.00	Professional	26	$11.59	$26.37	$132.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.94 / $50.42 / $705.08	Professional	TC	$14.94	$50.42	$705.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $37.43 / $75.34	Professional		$19.34	$37.43	$75.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.05 / $74.98 / $270.22	Professional		$50.05	$74.98	$270.22
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $22.50 / $132.00 / $132.00	Facility	26	$22.50	$132.00	$132.00
Quartz Facility/Professional Facility Modifier 53 Low / Median / High Price $11.88 / $53.18 / $53.18	Facility	53	$11.88	$53.18	$53.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.83 / $431.17 / $761.56	Professional		$36.83	$431.17	$761.56
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.51 / $48.65 / $132.00	Professional	26	$14.51	$48.65	$132.00
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $25.17 / $398.26 / $705.08	Professional	TC	$25.17	$398.26	$705.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.24 / $155.79 / $332.46	Professional		$50.24	$155.79	$332.46
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $27.41 / $168.61	Professional	26	$21.66	$27.41	$168.61
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.58 / $36.15 / $279.10	Professional	TC	$28.58	$36.15	$279.10
United Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $59.89 / $238.21	Professional		$25.92	$59.89	$238.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.63 / $23.66 / $42.68	Professional	26	$10.63	$23.66	$42.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.33 / $36.65 / $218.81	Professional	TC	$14.33	$36.65	$218.81