Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.19 / $49.19 / $69.53	Facility	26	$49.19	$49.19	$69.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $112.59 / $1,805.00	Professional		$62.40	$112.59	$1,805.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $219.52 / $1,130.53	Professional	26	$34.22	$219.52	$1,130.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $49.07 / $197.51	Professional	TC	$35.34	$49.07	$197.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $129.31 / $397.14	Professional		$63.39	$129.31	$397.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.74 / $64.43 / $200.76	Professional	26	$31.74	$64.43	$200.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $65.28 / $196.37	Professional	TC	$31.66	$65.28	$196.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.21 / $43.13 / $84.35	Professional		$41.21	$43.13	$84.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.51 / $101.09 / $155.08	Facility	26	$86.51	$101.09	$155.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $295.37 / $335.65	Professional		$92.94	$295.37	$335.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.18 / $145.79 / $165.68	Professional	26	$42.18	$145.79	$165.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.11 / $149.58 / $169.98	Professional	TC	$49.11	$149.58	$169.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.87 / $171.31 / $468.00	Professional		$76.87	$171.31	$468.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.42 / $78.23 / $378.10	Professional	26	$36.42	$78.23	$378.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.77 / $87.68 / $378.10	Professional	TC	$38.77	$87.68	$378.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $59.06 / $125.82	Professional		$25.48	$59.06	$125.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.30 / $196.71 / $280.93	Professional		$131.30	$196.71	$280.93
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $170.00 / $170.00 / $170.00	Facility	26	$170.00	$170.00	$170.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $110.48 / $324.25 / $468.00	Professional		$110.48	$324.25	$468.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $162.69 / $378.10	Professional	26	$54.53	$162.69	$378.10
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $55.94 / $161.55 / $378.10	Professional	TC	$55.94	$161.55	$378.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $222.97 / $405.59 / $405.59	Professional		$222.97	$405.59	$405.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.21 / $112.46 / $184.99	Professional	26	$106.21	$112.46	$184.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $108.50 / $113.36 / $213.92	Professional	TC	$108.50	$113.36	$213.92
United Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $154.22 / $323.69	Professional		$72.56	$154.22	$323.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $73.94 / $149.62	Professional	26	$35.47	$73.94	$149.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.77 / $85.35 / $167.98	Professional	TC	$38.77	$85.35	$167.98