Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.05 / $16.28 / $19.67	Facility	26	$10.05	$16.28	$19.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.33 / $86.79 / $437.75	Professional		$36.33	$86.79	$437.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $14.73 / $114.12	Professional	26	$8.94	$14.73	$114.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.61 / $77.39 / $231.35	Professional	TC	$26.61	$77.39	$231.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $87.04 / $226.34	Professional		$36.61	$87.04	$226.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $21.11 / $58.81	Professional	26	$9.14	$21.11	$58.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.47 / $65.31 / $167.53	Professional	TC	$27.47	$65.31	$167.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $34.71 / $53.12	Professional		$10.45	$34.71	$53.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.33 / $28.43 / $37.79	Facility	26	$24.33	$28.43	$37.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $136.69 / $155.33	Professional		$56.42	$136.69	$155.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $33.11 / $37.64	Professional	26	$11.15	$33.11	$37.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.87 / $103.57 / $117.69	Professional	TC	$42.87	$103.57	$117.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $80.00 / $80.00	Facility	26	$80.00	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $113.79 / $539.95	Professional		$43.99	$113.79	$539.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $27.57 / $97.55	Professional	26	$11.09	$27.57	$97.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $91.31 / $492.53	Professional	TC	$32.40	$91.31	$492.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $37.91 / $85.00	Professional		$19.34	$37.91	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $114.91 / $195.54	Professional		$76.70	$114.91	$195.54
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $22.50 / $80.00 / $80.00	Facility	26	$22.50	$80.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.33 / $299.14 / $539.95	Professional		$63.33	$299.14	$539.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.63 / $48.65 / $97.55	Professional	26	$14.63	$48.65	$97.55
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $47.98 / $264.06 / $492.53	Professional	TC	$47.98	$264.06	$492.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $277.22 / $380.73 / $380.73	Professional		$277.22	$380.73	$380.73
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.77 / $95.54 / $95.54	Professional	26	$41.77	$95.54	$95.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $210.66 / $285.20 / $285.20	Professional	TC	$210.66	$285.20	$285.20
United Facility/Professional Professional Modifier Low / Median / High Price $43.24 / $102.41 / $214.98	Professional		$43.24	$102.41	$214.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $22.27 / $42.64	Professional	26	$10.22	$22.27	$42.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $74.48 / $207.19	Professional	TC	$30.20	$74.48	$207.19