Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $56.23 / $83.18	Facility	26	$35.48	$56.23	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $74.13 / $245.47	Professional		$33.11	$74.13	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $52.48 / $186.21	Professional	26	$19.95	$52.48	$186.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $69.18 / $263.03	Professional	50	$36.31	$69.18	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $25.12 / $66.07	Professional	TC	$8.91	$25.12	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $69.18 / $251.19	Professional		$40.74	$69.18	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $45.71 / $125.89	Professional	26	$24.55	$45.71	$125.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $102.33 / $371.54	Professional	50	$61.66	$102.33	$371.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $28.18 / $123.03	Professional	TC	$8.71	$28.18	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $109.65	Professional		$30.90	$50.12	$109.65
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 $39.81 / $128.82 / $257.04	Professional		$39.81	$128.82	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $67.61 / $131.83	Professional	26	$25.12	$67.61	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $63.10 / $125.89	Professional	TC	$13.80	$63.10	$125.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $173.78	Professional		$114.82	$131.83	$173.78
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $64.57 / $87.10	Professional	26	$58.88	$64.57	$87.10
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $64.57 / $85.11	Professional	TC	$56.23	$64.57	$85.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $147.91 / $147.91	Facility	26	$134.90	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $75.86 / $363.08	Professional		$37.15	$75.86	$363.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $46.77 / $199.53	Professional	26	$24.55	$46.77	$199.53
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $34.67 / $213.80	Professional	TC	$12.59	$34.67	$213.80
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 $60.26 / $151.36 / $223.87	Professional		$60.26	$151.36	$223.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $162.18 / $162.18	Facility	26	$75.86	$162.18	$162.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $275.42 / $363.08	Professional		$47.86	$275.42	$363.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $138.04 / $194.98	Professional	26	$24.55	$138.04	$194.98
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $154.88 / $213.80	Professional	TC	$19.95	$154.88	$213.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $194.98 / $398.11	Professional		$87.10	$194.98	$398.11
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $117.49	Professional	26	$57.54	$70.79	$117.49
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $31.62 / $114.82	Professional	TC	$26.92	$31.62	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $66.07 / $173.78	Professional		$38.02	$66.07	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $79.43	Professional	26	$24.55	$36.31	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $36.31 / $100.00	Professional	TC	$12.59	$36.31	$100.00