Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $36.31 / $43.65	Facility	26	$30.90	$36.31	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $120.23	Professional		$50.12	$69.18	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.39 / $52.48	Professional	26	$16.98	$22.39	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $45.71 / $79.43	Professional	TC	$33.11	$45.71	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $338.84	Professional		$63.10	$97.72	$338.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $31.62 / $109.65	Professional	26	$20.42	$31.62	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $66.07 / $223.87	Professional	TC	$42.66	$66.07	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $64.57 / $102.33	Facility	26	$54.95	$64.57	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $138.04 / $269.15	Professional		$66.07	$138.04	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $44.67 / $85.11	Professional	26	$21.88	$44.67	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $95.50 / $181.97	Professional	TC	$43.65	$95.50	$181.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $194.98	Professional		$120.23	$144.54	$194.98
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $45.71 / $61.66	Professional	26	$38.02	$45.71	$61.66
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $97.72 / $134.90	Professional	TC	$83.18	$97.72	$134.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $114.82 / $416.87	Professional		$64.57	$114.82	$416.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $41.69 / $131.83	Professional	26	$22.91	$41.69	$131.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $75.86 / $288.40	Professional	TC	$41.69	$75.86	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $229.09	Professional		$81.28	$151.36	$229.09
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $131.83 / $131.83	Facility	26	$48.98	$131.83	$131.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $302.00 / $416.87	Professional		$72.44	$302.00	$416.87
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $109.65 / $131.83	Professional	26	$23.99	$109.65	$131.83
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $194.98 / $288.40	Professional	TC	$48.98	$194.98	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $407.38 / $562.34	Professional		$380.19	$407.38	$562.34
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $151.36 / $208.93	Professional	26	$85.11	$151.36	$208.93
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $302.00 / $371.54	Professional	TC	$97.72	$302.00	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $223.87	Professional		$64.57	$95.50	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $33.88 / $74.13	Professional	26	$22.39	$33.88	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $61.66 / $144.54	Professional	TC	$41.69	$61.66	$144.54