Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $50.12	Facility	26	$34.67	$34.67	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $165.96	Professional		$33.11	$57.54	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $39.81 / $97.72	Professional	26	$21.88	$39.81	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $20.89 / $58.88	Professional	TC	$10.96	$20.89	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $70.79 / $245.47	Professional		$37.15	$70.79	$245.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $36.31 / $131.83	Professional	26	$23.44	$36.31	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $32.36 / $138.04	Professional	TC	$13.49	$32.36	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $31.62 / $51.29	Professional		$20.42	$31.62	$51.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $74.13 / $120.23	Facility	26	$64.57	$74.13	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $131.83 / $204.17	Professional		$63.10	$131.83	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $77.62 / $123.03	Professional	26	$34.67	$77.62	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $60.26 / $79.43	Professional	TC	$25.70	$60.26	$79.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $123.03	Professional		$81.28	$95.50	$123.03
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $60.26 / $67.61	Professional	26	$47.86	$60.26	$67.61
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.90 / $50.12	Professional	TC	$33.11	$38.90	$50.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $125.89 / $436.52	Professional		$54.95	$125.89	$436.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $56.23 / $338.84	Professional	26	$28.18	$56.23	$338.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $75.86 / $338.84	Professional	TC	$26.92	$75.86	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $223.87	Professional		$66.07	$117.49	$223.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $147.91 / $147.91	Facility	26	$100.00	$147.91	$147.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $257.04 / $446.68	Professional		$66.07	$257.04	$446.68
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $117.49 / $338.84	Professional	26	$34.67	$117.49	$338.84
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $169.82 / $338.84	Professional	TC	$27.54	$169.82	$338.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $239.88 / $354.81	Professional		$194.98	$239.88	$354.81
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $141.25	Professional	26	$79.43	$93.33	$141.25
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $144.54 / $181.97	Professional	TC	$81.28	$144.54	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $102.33 / $208.93	Professional		$46.77	$102.33	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $45.71 / $104.71	Professional	26	$25.70	$45.71	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $56.23 / $128.82	Professional	TC	$18.62	$56.23	$128.82