Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.57 / $49.41 / $49.79	Facility	26	$35.57	$49.41	$49.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.87 / $116.97 / $484.27	Professional		$50.87	$116.97	$484.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $41.54 / $196.65	Professional	26	$18.78	$41.54	$196.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $55.26 / $100.45	Professional	TC	$21.65	$55.26	$100.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $82.01 / $269.51	Professional		$47.20	$82.01	$269.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.95 / $37.47 / $134.44	Professional	26	$22.95	$37.47	$134.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $45.59 / $150.75	Professional	TC	$22.89	$45.59	$150.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.72 / $31.87 / $62.86	Professional		$23.72	$31.87	$62.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.28 / $71.61 / $109.85	Facility	26	$61.28	$71.61	$109.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.11 / $173.86 / $197.56	Professional		$72.11	$173.86	$197.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $81.99 / $93.18	Professional	26	$25.42	$81.99	$93.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.07 / $91.86 / $104.39	Professional	TC	$38.07	$91.86	$104.39
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $115.00 / $115.00 / $115.00	Facility	26	$115.00	$115.00	$115.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $124.58 / $575.66	Professional		$55.20	$124.58	$575.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.48 / $55.72 / $232.81	Professional	26	$23.48	$55.72	$232.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.11 / $72.81 / $398.91	Professional	TC	$26.11	$72.81	$398.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $60.55 / $129.94	Professional		$25.45	$60.55	$129.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.62 / $141.87 / $209.59	Professional		$93.62	$141.87	$209.59
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $115.00 / $115.00	Facility	26	$100.00	$115.00	$115.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $259.83 / $575.66	Professional		$73.22	$259.83	$575.66
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $34.53 / $122.20 / $232.81	Professional	26	$34.53	$122.20	$232.81
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $38.68 / $200.83 / $398.91	Professional	TC	$38.68	$200.83	$398.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $137.71 / $309.79 / $309.79	Professional		$137.71	$309.79	$309.79
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.72 / $71.98 / $103.88	Professional	26	$63.72	$71.98	$103.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.70 / $91.04 / $433.14	Professional	TC	$65.70	$91.04	$433.14
United Facility/Professional Professional Modifier Low / Median / High Price $52.90 / $107.69 / $206.68	Professional		$52.90	$107.69	$206.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.96 / $41.69 / $94.09	Professional	26	$21.96	$41.69	$94.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $60.02 / $118.24	Professional	TC	$25.39	$60.02	$118.24