Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $41.69 / $61.66	Facility	26	$34.67	$41.69	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $302.00	Professional		$38.90	$77.62	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $43.65 / $134.90	Professional	26	$19.95	$43.65	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.44 / $48.98	Professional	TC	$16.98	$23.44	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $234.42	Professional		$43.65	$67.61	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $117.49	Professional	26	$22.91	$36.31	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $109.65	Professional	TC	$20.42	$31.62	$109.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $36.31 / $79.43	Professional		$21.88	$36.31	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $72.44 / $114.82	Facility	26	$61.66	$72.44	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $112.20 / $181.97	Professional		$48.98	$112.20	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $53.70 / $97.72	Professional	26	$26.30	$53.70	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $63.10 / $85.11	Professional	TC	$22.39	$63.10	$85.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $91.20 / $123.03	Professional		$79.43	$91.20	$123.03
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $48.98 / $66.07	Professional	26	$43.65	$48.98	$66.07
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $57.54	Professional	TC	$37.15	$43.65	$57.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $501.19	Professional		$48.98	$102.33	$501.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $47.86 / $151.36	Professional	26	$25.70	$47.86	$151.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $46.77 / $371.54	Professional	TC	$21.88	$46.77	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $114.82 / $194.98	Professional		$57.54	$114.82	$194.98
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $151.36 / $151.36	Facility	26	$54.95	$151.36	$151.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $295.12 / $501.19	Professional		$43.65	$295.12	$501.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $123.03 / $151.36	Professional	26	$23.44	$123.03	$151.36
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $204.17 / $380.19	Professional	TC	$19.95	$204.17	$380.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $281.84	Professional		$138.04	$223.87	$281.84
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $74.13 / $114.82	Professional	26	$63.10	$74.13	$114.82
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $91.20	Professional	TC	$53.70	$63.10	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $70.79 / $169.82	Professional		$47.86	$70.79	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $35.48 / $81.28	Professional	26	$25.70	$35.48	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $85.11	Professional	TC	$21.38	$33.11	$85.11