Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $63.10 / $93.33	Facility	26	$54.95	$63.10	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $165.96 / $549.54	Professional		$74.13	$165.96	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $74.13 / $239.88	Professional	26	$32.36	$74.13	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $57.54 / $117.49	Professional	TC	$38.02	$57.54	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $436.52	Professional		$81.28	$125.89	$436.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $54.95 / $181.97	Professional	26	$35.48	$54.95	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $70.79 / $239.88	Professional	TC	$45.71	$70.79	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $69.18 / $158.49	Professional		$41.69	$69.18	$158.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $114.82 / $181.97	Facility	26	$97.72	$114.82	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $199.53 / $346.74	Professional		$93.33	$199.53	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $85.11 / $151.36	Professional	26	$39.81	$85.11	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $117.49 / $199.53	Professional	TC	$52.48	$117.49	$199.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $239.88	Professional		$154.88	$177.83	$239.88
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $75.86 / $102.33	Professional	26	$66.07	$75.86	$102.33
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $102.33 / $138.04	Professional	TC	$89.13	$102.33	$138.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $338.84	Facility	26	$162.18	$162.18	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $194.98 / $549.54	Professional		$93.33	$194.98	$549.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $77.62 / $269.15	Professional	26	$39.81	$77.62	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $91.20 / $354.81	Professional	TC	$50.12	$91.20	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $323.59	Professional		$112.20	$204.17	$323.59
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $234.42 / $234.42	Facility	26	$100.00	$234.42	$234.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $426.58 / $575.44	Professional		$89.13	$426.58	$575.44
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $190.55 / $269.15	Professional	26	$36.31	$190.55	$269.15
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $234.42 / $354.81	Professional	TC	$48.98	$234.42	$354.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $331.13 / $537.03	Professional		$257.04	$331.13	$537.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $131.83 / $173.78	Professional	26	$114.82	$131.83	$173.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $144.54 / $223.87	Professional	TC	$141.25	$144.54	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $295.12	Professional		$89.13	$120.23	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $125.89	Professional	26	$38.90	$53.70	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $69.18 / $165.96	Professional	TC	$48.98	$69.18	$165.96