Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.94 / $35.94 / $50.65	Facility	26	$35.94	$35.94	$50.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.52 / $68.44 / $194.66	Professional		$39.52	$68.44	$194.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.47 / $35.94 / $164.35	Professional	26	$24.47	$35.94	$164.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.05 / $31.72 / $133.37	Professional	TC	$15.05	$31.72	$133.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.82 / $90.75 / $248.89	Professional		$36.82	$90.75	$248.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.19 / $49.74 / $148.84	Professional	26	$23.19	$49.74	$148.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.63 / $40.92 / $116.47	Professional	TC	$13.63	$40.92	$116.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $31.36 / $51.78	Professional		$20.42	$31.36	$51.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.98 / $74.77 / $114.69	Facility	26	$63.98	$74.77	$114.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $175.97 / $199.96	Professional		$62.42	$175.97	$199.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $106.91 / $121.49	Professional	26	$33.79	$106.91	$121.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.88 / $69.06 / $78.48	Professional	TC	$25.88	$69.06	$78.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $131.40 / $441.00	Professional		$55.25	$131.40	$441.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $62.53 / $338.48	Professional	26	$28.41	$62.53	$338.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.84 / $77.42 / $338.48	Professional	TC	$26.84	$77.42	$338.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $54.56 / $77.04	Professional		$19.71	$54.56	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $119.78 / $224.35	Professional		$79.95	$119.78	$224.35
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $120.92 / $120.92 / $120.92	Facility	26	$120.92	$120.92	$120.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $243.95 / $441.00	Professional		$65.81	$243.95	$441.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $118.35 / $338.48	Professional	26	$39.97	$118.35	$338.48
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $25.84 / $159.99 / $338.48	Professional	TC	$25.84	$159.99	$338.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $197.24 / $241.65 / $276.74	Professional		$197.24	$241.65	$276.74
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.93 / $98.31 / $162.03	Professional	26	$79.93	$98.31	$162.03
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.70 / $145.08 / $317.26	Professional	TC	$81.70	$145.08	$317.26
United Facility/Professional Professional Modifier Low / Median / High Price $49.34 / $121.62 / $239.16	Professional		$49.34	$121.62	$239.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $54.05 / $109.11	Professional	26	$26.94	$54.05	$109.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $65.03 / $132.16	Professional	TC	$23.82	$65.03	$132.16