Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $48.98 / $72.44	Facility	26	$41.69	$48.98	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $245.47	Professional		$85.11	$123.03	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.11 / $107.15	Professional	26	$22.91	$33.11	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $79.43 / $162.18	Professional	TC	$60.26	$79.43	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $478.63	Professional		$100.00	$154.88	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $42.66 / $138.04	Professional	26	$27.54	$42.66	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $112.20 / $354.81	Professional	TC	$72.44	$112.20	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $93.33 / $218.78	Professional		$32.36	$93.33	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $87.10 / $138.04	Facility	26	$74.13	$87.10	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $251.19 / $426.58	Professional		$109.65	$251.19	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $66.07 / $114.82	Professional	26	$30.90	$66.07	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $186.21 / $309.03	Professional	TC	$79.43	$186.21	$309.03
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 $51.29 / $58.88 / $79.43	Professional	26	$51.29	$58.88	$79.43
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $162.18 / $218.78	Professional	TC	$141.25	$162.18	$218.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $186.21 / $676.08	Professional		$109.65	$186.21	$676.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $52.48 / $181.97	Professional	26	$30.20	$52.48	$181.97
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $131.83 / $489.78	Professional	TC	$79.43	$131.83	$489.78
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 $144.54 / $263.03 / $371.54	Professional		$144.54	$263.03	$371.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $181.97 / $181.97	Facility	26	$66.07	$181.97	$181.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $524.81 / $676.08	Professional		$95.50	$524.81	$676.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $144.54 / $181.97	Professional	26	$25.12	$144.54	$181.97
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $371.54 / $489.78	Professional	TC	$70.79	$371.54	$489.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $363.08 / $660.69	Professional		$263.03	$363.08	$660.69
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $109.65	Professional	26	$72.44	$85.11	$109.65
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $218.78 / $281.84	Professional	TC	$186.21	$218.78	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $363.08	Professional		$109.65	$144.54	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $97.72	Professional	26	$30.20	$40.74	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $104.71 / $269.15	Professional	TC	$79.43	$104.71	$269.15