Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $70.79 / $104.71	Facility	26	$45.71	$70.79	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $229.09 / $630.96	Professional		$95.50	$229.09	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $87.10 / $309.03	Professional	26	$36.31	$87.10	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.28 / $194.98	Professional	TC	$54.95	$81.28	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $524.81	Professional		$107.15	$165.96	$524.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $204.17	Professional	26	$39.81	$61.66	$204.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $104.71 / $346.74	Professional	TC	$67.61	$104.71	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $89.13 / $218.78	Professional		$46.77	$89.13	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $125.89 / $199.53	Facility	26	$107.15	$125.89	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $234.42 / $446.68	Professional		$107.15	$234.42	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $93.33 / $165.96	Professional	26	$44.67	$93.33	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $158.49 / $281.84	Professional	TC	$66.07	$158.49	$281.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $229.09 / $302.00	Professional		$199.53	$229.09	$302.00
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $114.82	Professional	26	$74.13	$85.11	$114.82
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $141.25 / $190.55	Professional	TC	$125.89	$141.25	$190.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $251.19 / $707.95	Professional		$114.82	$251.19	$707.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $95.50 / $257.04	Professional	26	$44.67	$95.50	$257.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $128.82 / $446.68	Professional	TC	$70.79	$128.82	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $125.89	Professional		$32.36	$33.11	$125.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $263.03 / $478.63	Professional		$144.54	$263.03	$478.63
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $257.04 / $257.04	Facility	26	$100.00	$257.04	$257.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $549.54 / $707.95	Professional		$102.33	$549.54	$707.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $208.93 / $257.04	Professional	26	$39.81	$208.93	$257.04
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $338.84 / $446.68	Professional	TC	$66.07	$338.84	$446.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $416.87 / $691.83	Professional		$194.98	$416.87	$691.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $125.89 / $194.98	Professional	26	$100.00	$125.89	$194.98
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $204.17 / $331.13	Professional	TC	$97.72	$204.17	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $371.54	Professional		$112.20	$151.36	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $58.88 / $138.04	Professional	26	$43.65	$58.88	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $95.50 / $239.88	Professional	TC	$69.18	$95.50	$239.88