Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $56.23 / $69.18	Facility	26	$48.98	$56.23	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $169.82 / $630.96	Professional		$89.13	$169.82	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $53.70 / $181.97	Professional	26	$28.84	$53.70	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $85.11 / $181.97	Professional	TC	$60.26	$85.11	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $501.19	Professional		$102.33	$158.49	$501.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $48.98 / $158.49	Professional	26	$31.62	$48.98	$158.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $109.65 / $346.74	Professional	TC	$70.79	$109.65	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $87.10 / $218.78	Professional		$37.15	$87.10	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $100.00 / $158.49	Facility	26	$85.11	$100.00	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $257.04 / $426.58	Professional		$109.65	$257.04	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $74.13 / $131.83	Professional	26	$35.48	$74.13	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $177.83 / $295.12	Professional	TC	$75.86	$177.83	$295.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $218.78 / $295.12	Professional		$190.55	$218.78	$295.12
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $67.61 / $91.20	Professional	26	$58.88	$67.61	$91.20
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $151.36 / $199.53	Professional	TC	$131.83	$151.36	$199.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $371.54	Facility	26	$169.82	$169.82	$371.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $239.88 / $812.83	Professional		$112.20	$239.88	$812.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $79.43 / $257.04	Professional	26	$35.48	$79.43	$257.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $141.25 / $478.63	Professional	TC	$75.86	$141.25	$478.63
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 $134.90 / $263.03 / $457.09	Professional		$134.90	$263.03	$457.09
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $208.93 / $208.93	Facility	26	$100.00	$208.93	$208.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $537.03 / $691.83	Professional		$109.65	$537.03	$691.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $169.82 / $257.04	Professional	26	$32.36	$169.82	$257.04
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $363.08 / $478.63	Professional	TC	$70.79	$363.08	$478.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $398.11 / $724.44	Professional		$275.42	$398.11	$724.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $154.88	Professional	26	$100.00	$117.49	$154.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $213.80 / $346.74	Professional	TC	$151.36	$213.80	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $371.54	Professional		$109.65	$158.49	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $47.86 / $109.65	Professional	26	$34.67	$47.86	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $109.65 / $257.04	Professional	TC	$75.86	$109.65	$257.04