Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.06 / $56.78 / $69.13	Facility	26	$35.06	$56.78	$69.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $108.41 / $399.00	Professional		$30.18	$108.41	$399.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.03 / $80.50 / $345.80	Professional	26	$20.03	$80.50	$345.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.77 / $69.77 / $69.90	Professional	50	$69.77	$69.77	$69.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $13.64 / $106.98	Professional	TC	$9.18	$13.64	$106.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $78.89 / $314.83	Professional		$40.65	$78.89	$314.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.24 / $49.38 / $152.41	Professional	26	$24.24	$49.38	$152.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $60.97 / $123.76 / $472.24	Professional	50	$60.97	$123.76	$472.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.80 / $31.51 / $167.84	Professional	TC	$8.80	$31.51	$167.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $41.88 / $81.15	Professional		$30.40	$41.88	$81.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.61 / $100.04 / $153.46	Facility	26	$85.61	$100.04	$153.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.94 / $222.54 / $252.89	Professional		$55.94	$222.54	$252.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.54 / $114.27 / $129.85	Professional	26	$28.54	$114.27	$129.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.36 / $108.27 / $123.04	Professional	TC	$23.36	$108.27	$123.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.00 / $148.36 / $148.36	Facility	26	$134.00	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.67 / $103.89 / $359.16	Professional		$41.67	$103.89	$359.16
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $54.90 / $197.46	Professional	26	$25.98	$54.90	$197.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.04 / $40.65 / $214.27	Professional	TC	$14.04	$40.65	$214.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $59.06 / $126.60	Professional		$25.07	$59.06	$126.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $152.24 / $249.10	Professional		$40.39	$152.24	$249.10
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $77.63 / $148.36 / $148.36	Facility	26	$77.63	$148.36	$148.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.91 / $276.80 / $359.16	Professional		$65.91	$276.80	$359.16
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $30.81 / $139.72 / $197.46	Professional	26	$30.81	$139.72	$197.46
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $33.34 / $156.40 / $214.27	Professional	TC	$33.34	$156.40	$214.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.29 / $396.58 / $396.58	Professional		$92.29	$396.58	$396.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.66 / $70.94 / $132.11	Professional	26	$57.66	$70.94	$132.11
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $31.59 / $108.85	Professional	TC	$26.85	$31.59	$108.85
United Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $81.34 / $242.62	Professional		$40.72	$81.34	$242.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.15 / $48.88 / $105.54	Professional	26	$25.15	$48.88	$105.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $37.53 / $120.43	Professional	TC	$13.80	$37.53	$120.43