Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $42.66 / $60.26	Facility	26	$26.92	$42.66	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $79.43 / $208.93	Professional		$45.71	$79.43	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $53.70 / $125.89	Professional	26	$26.30	$53.70	$125.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.30 / $48.98 / $134.90	Professional	52	$26.30	$48.98	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $37.15 / $109.65	Professional	TC	$19.95	$37.15	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $234.42	Professional		$48.98	$72.44	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $39.81 / $128.82	Professional	26	$27.54	$39.81	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $34.67 / $107.15	Professional	TC	$22.91	$34.67	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $77.62	Professional		$26.30	$37.15	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $89.13 / $138.04	Facility	26	$79.43	$89.13	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $112.20 / $213.80	Professional		$53.70	$112.20	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $60.26 / $114.82	Professional	26	$30.20	$60.26	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $51.29 / $97.72	Professional	TC	$23.99	$51.29	$97.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $158.49	Professional		$97.72	$114.82	$158.49
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $85.11	Professional	26	$52.48	$63.10	$85.11
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $72.44	Professional	TC	$44.67	$52.48	$72.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $128.82 / $128.82	Facility	26	$31.62	$128.82	$128.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $100.00 / $331.13	Professional		$58.88	$100.00	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $54.95 / $147.91	Professional	26	$33.88	$54.95	$147.91
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $41.69 / $72.44 / $74.13	Professional	52	$41.69	$72.44	$74.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $151.36	Professional	TC	$26.30	$42.66	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $120.23 / $181.97	Professional		$66.07	$120.23	$181.97
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 $66.07 / $269.15 / $331.13	Professional		$66.07	$269.15	$331.13
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $147.91 / $181.97	Professional	26	$35.48	$147.91	$181.97
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $120.23 / $151.36	Professional	TC	$30.90	$120.23	$151.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $147.91 / $331.13	Professional		$66.07	$147.91	$331.13
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $93.33	Professional	26	$61.66	$72.44	$93.33
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $60.26 / $83.18	Professional	TC	$50.12	$60.26	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $83.18 / $194.98	Professional		$56.23	$83.18	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $107.15	Professional	26	$30.90	$45.71	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.02 / $87.10	Professional	TC	$25.12	$38.02	$87.10