Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.90 / $41.29 / $49.86	Facility	26	$35.90	$41.29	$49.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $92.92 / $504.00	Professional		$41.75	$92.92	$504.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $42.98 / $197.10	Professional	26	$21.37	$42.98	$197.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $25.42 / $60.62	Professional	TC	$18.48	$25.42	$60.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $79.86 / $250.02	Professional		$43.55	$79.86	$250.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $38.54 / $136.33	Professional	26	$23.17	$38.54	$136.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $38.33 / $115.13	Professional	TC	$20.39	$38.33	$115.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.10 / $28.60 / $55.64	Professional		$21.10	$28.60	$55.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.18 / $72.66 / $111.46	Facility	26	$62.18	$72.66	$111.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.79 / $158.21 / $179.79	Professional		$63.79	$158.21	$179.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.95 / $83.94 / $95.39	Professional	26	$29.95	$83.94	$95.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.43 / $74.26 / $84.39	Professional	TC	$29.43	$74.26	$84.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $105.96 / $105.96 / $105.96	Facility	26	$105.96	$105.96	$105.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.08 / $118.33 / $495.56	Professional		$50.08	$118.33	$495.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $56.50 / $151.44	Professional	26	$26.90	$56.50	$151.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $53.81 / $367.63	Professional	TC	$22.02	$53.81	$367.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $59.35 / $126.60	Professional		$25.48	$59.35	$126.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.38 / $125.66 / $198.00	Professional		$82.38	$125.66	$198.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $57.03 / $105.96 / $105.96	Facility	26	$57.03	$105.96	$105.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.63 / $277.99 / $495.56	Professional		$66.63	$277.99	$495.56
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $123.90 / $151.44	Professional	26	$35.35	$123.90	$151.44
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.28 / $196.29 / $367.63	Professional	TC	$31.28	$196.29	$367.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.19 / $281.86 / $281.86	Professional		$138.19	$281.86	$281.86
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.31 / $74.48 / $138.36	Professional	26	$63.31	$74.48	$138.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.15 / $63.71 / $89.36	Professional	TC	$54.15	$63.71	$89.36
United Facility/Professional Professional Modifier Low / Median / High Price $48.80 / $93.17 / $199.18	Professional		$48.80	$93.17	$199.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.89 / $50.30 / $119.16	Professional	26	$26.89	$50.30	$119.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $49.81 / $116.02	Professional	TC	$22.02	$49.81	$116.02