Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $109.65 / $134.90	Facility		$15.85	$109.65	$134.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $10.96 / $15.85	Facility	26	$10.96	$10.96	$15.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $17.38 / $50.12	Professional		$9.77	$17.38	$50.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $32.36	Professional	26	$6.03	$8.91	$32.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $29.51 / $29.51	Professional	50	$29.51	$29.51	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.98 / $7.76	Professional	TC	$2.00	$3.98	$7.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $16.98 / $57.54	Professional		$10.72	$16.98	$57.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.75 / $39.81	Professional	26	$7.41	$11.75	$39.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $16.22 / $25.70 / $87.10	Professional	50	$16.22	$25.70	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.31 / $5.89 / $18.62	Professional	TC	$3.31	$5.89	$18.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.68 / $10.96 / $18.20	Facility		$4.68	$10.96	$18.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.89 / $9.77 / $25.12	Professional		$3.89	$9.77	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $33.88 / $53.70	Facility		$25.70	$33.88	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.91 / $37.15	Facility	26	$19.95	$22.91	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $26.30 / $45.71	Professional		$12.88	$26.30	$45.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $18.20 / $30.90	Professional	26	$8.71	$18.20	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $8.32 / $14.13	Professional	TC	$3.89	$8.32	$14.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $21.38 / $112.20	Facility		$10.23	$21.38	$112.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $23.44 / $33.88	Professional		$20.42	$23.44	$33.88
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.85 / $22.91	Professional	26	$14.13	$15.85	$22.91
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $7.24 / $10.47	Professional	TC	$6.31	$7.24	$10.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $17.78 / $63.10	Facility		$10.23	$17.78	$63.10
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 $12.30 / $23.44 / $1,412.54	Professional		$12.30	$23.44	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.22 / $1,288.25	Professional	26	$8.71	$16.22	$1,288.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $7.41 / $977.24	Professional	TC	$3.72	$7.41	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $33.11 / $64.57	Professional		$19.50	$33.11	$64.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $27.54 / $41.69	Professional		$10.96	$27.54	$41.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $79.43 / $79.43	Facility		$25.70	$79.43	$79.43
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $100.00 / $100.00	Facility	26	$17.78	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $57.54 / $1,412.54	Professional		$12.88	$57.54	$1,412.54
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $39.81 / $1,288.25	Professional	26	$8.32	$39.81	$1,288.25
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $3.63 / $17.78 / $977.24	Professional	TC	$3.63	$17.78	$977.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $52.48 / $85.11	Professional		$18.20	$52.48	$85.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $28.18 / $36.31	Professional	26	$15.14	$28.18	$36.31
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $14.45 / $18.20	Professional	TC	$3.02	$14.45	$18.20
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $102.33	Facility		$77.62	$77.62	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $19.05 / $42.66	Professional		$12.30	$19.05	$42.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $28.84	Professional	26	$8.32	$12.02	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $6.03 / $13.18	Professional	TC	$3.72	$6.03	$13.18