Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.78 / $64.76 / $64.76	Facility	26	$46.78	$64.76	$64.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.59 / $174.40 / $589.00	Professional		$82.59	$174.40	$589.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.94 / $94.15 / $280.50	Professional	26	$29.94	$94.15	$280.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.24 / $74.70 / $169.05	Professional	TC	$44.24	$74.70	$169.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.90 / $122.29 / $448.14	Professional		$78.90	$122.29	$448.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.18 / $49.07 / $176.16	Professional	26	$30.18	$49.07	$176.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.72 / $75.51 / $275.07	Professional	TC	$48.72	$75.51	$275.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $57.97 / $100.28	Professional		$32.95	$57.97	$100.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.09 / $94.77 / $145.38	Facility	26	$81.09	$94.77	$145.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $285.25 / $324.14	Professional		$101.65	$285.25	$324.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.32 / $107.79 / $122.49	Professional	26	$37.32	$107.79	$122.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.33 / $177.42 / $201.61	Professional	TC	$64.33	$177.42	$201.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $139.28 / $139.28 / $139.28	Facility	26	$139.28	$139.28	$139.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.34 / $192.44 / $524.64	Professional		$93.34	$192.44	$524.64
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $73.67 / $195.35	Professional	26	$34.86	$73.67	$195.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $56.38 / $112.70 / $329.23	Professional	TC	$56.38	$112.70	$329.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $64.69 / $188.51	Professional		$25.84	$64.69	$188.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.03 / $193.78 / $363.00	Professional		$151.03	$193.78	$363.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $139.28 / $139.28	Facility	26	$100.00	$139.28	$139.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.14 / $407.30 / $524.64	Professional		$120.14	$407.30	$524.64
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $160.15 / $195.35	Professional	26	$45.41	$160.15	$195.35
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $74.73 / $247.15 / $329.23	Professional	TC	$74.73	$247.15	$329.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $236.69 / $508.25 / $508.25	Professional		$236.69	$508.25	$508.25
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.25 / $106.21 / $175.24	Professional	26	$95.25	$106.21	$175.24
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.47 / $148.01 / $335.46	Professional	TC	$130.47	$148.01	$335.46
United Facility/Professional Professional Modifier Low / Median / High Price $89.81 / $166.32 / $357.00	Professional		$89.81	$166.32	$357.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $62.46 / $140.37	Professional	26	$33.60	$62.46	$140.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.38 / $96.64 / $216.63	Professional	TC	$54.38	$96.64	$216.63