Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $25.12 / $37.15	Facility	26	$20.89	$25.12	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $134.90	Professional		$42.66	$58.88	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $56.23	Professional	26	$12.02	$15.85	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $39.81 / $75.86	Professional	TC	$30.20	$39.81	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $263.03	Professional		$50.12	$77.62	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.88 / $75.86	Professional	26	$14.13	$21.88	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $56.23 / $186.21	Professional	TC	$35.48	$56.23	$186.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $43.65 / $69.18	Facility	26	$37.15	$43.65	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $109.65 / $218.78	Professional		$53.70	$109.65	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $30.90 / $57.54	Professional	26	$14.79	$30.90	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $85.11 / $158.49	Professional	TC	$38.02	$85.11	$158.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $162.18	Professional		$100.00	$117.49	$162.18
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $31.62 / $41.69	Professional	26	$25.70	$31.62	$41.69
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $87.10 / $112.20	Professional	TC	$74.13	$87.10	$112.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $234.42	Facility	26	$70.79	$70.79	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $100.00 / $323.59	Professional		$51.29	$100.00	$323.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $28.18 / $91.20	Professional	26	$14.45	$28.18	$91.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $72.44 / $234.42	Professional	TC	$37.15	$72.44	$234.42
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 $70.79 / $128.82 / $190.55	Professional		$70.79	$128.82	$190.55
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $91.20 / $91.20	Facility	26	$33.11	$91.20	$91.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $257.04 / $323.59	Professional		$66.07	$257.04	$323.59
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $74.13 / $91.20	Professional	26	$17.78	$74.13	$91.20
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $181.97 / $234.42	Professional	TC	$48.98	$181.97	$234.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $346.74 / $457.09	Professional		$316.23	$346.74	$457.09
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $114.82 / $141.25	Professional	26	$69.18	$114.82	$141.25
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $295.12 / $363.08	Professional	TC	$169.82	$295.12	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $81.28 / $190.55	Professional		$50.12	$81.28	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $22.39 / $53.70	Professional	26	$14.45	$22.39	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $57.54 / $134.90	Professional	TC	$37.15	$57.54	$134.90