Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $97.72	Facility	26	$67.61	$67.61	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $67.61 / $154.88	Professional		$47.86	$67.61	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $47.86 / $158.49	Professional	26	$37.15	$47.86	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $37.15	Professional	TC	$15.14	$19.95	$37.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $346.74	Professional		$63.10	$97.72	$346.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $251.19	Professional	26	$44.67	$69.18	$251.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.18 / $102.33	Professional	TC	$18.20	$28.18	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $141.25 / $229.09	Facility	26	$123.03	$141.25	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $208.93 / $338.84	Professional		$95.50	$208.93	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $147.91 / $239.88	Professional	26	$67.61	$147.91	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $63.10 / $100.00	Professional	TC	$27.54	$63.10	$100.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $151.36 / $181.97	Professional		$131.83	$151.36	$181.97
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $107.15 / $128.82	Professional	26	$93.33	$107.15	$128.82
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $44.67 / $53.70	Professional	TC	$38.02	$44.67	$53.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $407.38	Professional		$72.44	$141.25	$407.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $104.71 / $407.38	Professional	26	$50.12	$104.71	$407.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $41.69 / $407.38	Professional	TC	$20.89	$41.69	$407.38
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 $95.50 / $154.88 / $288.40	Professional		$95.50	$154.88	$288.40
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $288.40 / $288.40	Facility	26	$109.65	$288.40	$288.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $316.23 / $407.38	Professional		$95.50	$316.23	$407.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $229.09 / $407.38	Professional	26	$67.61	$229.09	$407.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $89.13 / $407.38	Professional	TC	$27.54	$89.13	$407.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $489.78	Professional		$213.80	$398.11	$489.78
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $257.04	Professional	26	$151.36	$151.36	$257.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $63.10 / $112.20	Professional	TC	$56.23	$63.10	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $281.84	Professional		$66.07	$117.49	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $83.18 / $204.17	Professional	26	$46.77	$83.18	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.88 / $79.43	Professional	TC	$19.05	$33.88	$79.43