Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.66 / $16.85 / $19.67	Facility	26	$14.66	$16.85	$19.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $39.95 / $156.00	Professional		$26.95	$39.95	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.74 / $11.65 / $48.28	Professional	26	$8.74	$11.65	$48.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $24.15 / $42.43	Professional	TC	$17.28	$24.15	$42.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $61.67 / $177.60	Professional		$30.17	$61.67	$177.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $21.85 / $60.87	Professional	26	$9.46	$21.85	$60.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $42.34 / $122.09	Professional	TC	$20.71	$42.34	$122.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $27.11 / $43.28	Professional		$10.45	$27.11	$43.28
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 $40.31 / $110.88 / $126.00	Professional		$40.31	$110.88	$126.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $33.11 / $37.64	Professional	26	$11.80	$33.11	$37.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.36 / $77.80 / $88.41	Professional	TC	$28.36	$77.80	$88.41
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 $32.84 / $82.10 / $197.88	Professional		$32.84	$82.10	$197.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.79 / $27.19 / $232.03	Professional	26	$10.79	$27.19	$232.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $55.50 / $142.29	Professional	TC	$22.13	$55.50	$142.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $36.29 / $74.33	Professional		$19.34	$36.29	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $75.72 / $121.31	Professional		$56.39	$75.72	$121.31
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 $47.39 / $155.40 / $197.88	Professional		$47.39	$155.40	$197.88
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $50.35 / $232.03	Professional	26	$15.21	$50.35	$232.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $32.76 / $125.00 / $142.29	Professional	TC	$32.76	$125.00	$142.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $197.59 / $206.34	Professional		$157.91	$197.59	$206.34
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $61.03 / $82.34	Professional	26	$30.35	$61.03	$82.34
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.87 / $124.06 / $158.79	Professional	TC	$96.87	$124.06	$158.79
United Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $73.73 / $151.46	Professional		$32.63	$73.73	$151.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $52.46 / $87.90	Professional	26	$16.18	$52.46	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $53.16 / $92.08	Professional	TC	$22.13	$53.16	$92.08