Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $56.23 / $67.61	Facility	26	$47.86	$56.23	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $295.12	Professional		$61.66	$85.11	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.11 / $123.03	Professional	26	$25.12	$33.11	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $204.17 / $741.31	Professional	50	$144.54	$204.17	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $46.77 / $93.33	Professional	TC	$33.88	$46.77	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $407.38	Professional		$72.44	$123.03	$407.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $48.98 / $165.96	Professional	26	$31.62	$48.98	$165.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.65 / $199.53 / $616.60	Professional	50	$109.65	$199.53	$616.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $77.62 / $234.42	Professional	TC	$41.69	$77.62	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $100.00 / $158.49	Facility	26	$85.11	$100.00	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $309.03	Professional		$89.13	$186.21	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $74.13 / $131.83	Professional	26	$34.67	$74.13	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $114.82 / $173.78	Professional	TC	$53.70	$114.82	$173.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $223.87	Professional		$134.90	$154.88	$223.87
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $67.61 / $91.20	Professional	26	$58.88	$67.61	$91.20
DeanCare Facility/Professional Professional Modifier 50 Low / Median / High Price $204.17 / $234.42 / $338.84	Professional	50	$204.17	$234.42	$338.84
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $87.10 / $125.89	Professional	TC	$77.62	$87.10	$125.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	26	$144.54	$144.54	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $588.84	Professional		$97.72	$177.83	$588.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $67.61 / $338.84	Professional	26	$36.31	$67.61	$338.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $109.65 / $354.81	Professional	TC	$60.26	$109.65	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $194.98 / $331.13	Professional		$97.72	$194.98	$331.13
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $199.53 / $199.53	Facility	26	$100.00	$199.53	$199.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $489.78 / $602.56	Professional		$93.33	$489.78	$602.56
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $177.83 / $338.84	Professional	26	$33.88	$177.83	$338.84
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $302.00 / $363.08	Professional	TC	$58.88	$302.00	$363.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $346.74 / $549.54	Professional		$251.19	$346.74	$549.54
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $151.36	Professional	26	$89.13	$104.71	$151.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $169.82 / $213.80	Professional	TC	$141.25	$169.82	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $309.03	Professional		$89.13	$131.83	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $117.49	Professional	26	$35.48	$50.12	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $81.28 / $199.53	Professional	TC	$52.48	$81.28	$199.53