Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $100.00 / $123.03	Facility	26	$45.71	$100.00	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $269.15 / $724.44	Professional		$120.23	$269.15	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $97.72 / $275.42	Professional	26	$41.69	$97.72	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $109.65 / $263.03	Professional	TC	$72.44	$109.65	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $630.96	Professional		$131.83	$204.17	$630.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $72.44 / $234.42	Professional	26	$45.71	$72.44	$234.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $131.83 / $416.87	Professional	TC	$85.11	$131.83	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $107.15 / $281.84	Professional		$54.95	$107.15	$281.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $144.54 / $234.42	Facility	26	$123.03	$144.54	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $316.23 / $549.54	Professional		$144.54	$316.23	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $109.65 / $190.55	Professional	26	$51.29	$109.65	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $208.93 / $363.08	Professional	TC	$91.20	$208.93	$363.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $281.84 / $380.19	Professional		$245.47	$281.84	$380.19
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $97.72 / $131.83	Professional	26	$85.11	$97.72	$131.83
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $181.97 / $245.47	Professional	TC	$158.49	$181.97	$245.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $436.52	Facility	26	$213.80	$213.80	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $288.40 / $870.96	Professional		$141.25	$288.40	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $102.33 / $295.12	Professional	26	$51.29	$102.33	$295.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $165.96 / $575.44	Professional	TC	$91.20	$165.96	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $588.84	Professional		$173.78	$316.23	$588.84
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $295.12 / $295.12	Facility	26	$109.65	$295.12	$295.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $724.44 / $870.96	Professional		$144.54	$724.44	$870.96
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $245.47 / $295.12	Professional	26	$46.77	$245.47	$295.12
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $436.52 / $575.44	Professional	TC	$93.33	$436.52	$575.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $512.86 / $851.14	Professional		$346.74	$512.86	$851.14
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $165.96 / $223.87	Professional	26	$144.54	$165.96	$223.87
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $263.03 / $416.87	Professional	TC	$181.97	$263.03	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $467.74	Professional		$141.25	$194.98	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $162.18	Professional	26	$50.12	$69.18	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $128.82 / $309.03	Professional	TC	$91.20	$128.82	$309.03