Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $85.11	Facility	26	$58.88	$58.88	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $128.82 / $269.15	Professional		$56.23	$128.82	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $41.69 / $128.82	Professional	26	$33.88	$41.69	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $91.20 / $190.55	Professional	TC	$18.20	$91.20	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $630.96	Professional		$107.15	$147.91	$630.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $58.88 / $213.80	Professional	26	$38.02	$58.88	$213.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $436.52	Professional	TC	$60.26	$95.50	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $123.03 / $194.98	Facility	26	$104.71	$123.03	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $398.11 / $707.95	Professional		$199.53	$398.11	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $128.82 / $204.17	Professional	26	$58.88	$128.82	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $269.15 / $501.19	Professional	TC	$131.83	$269.15	$501.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $389.05	Professional		$257.04	$302.00	$389.05
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $112.20	Professional	26	$79.43	$100.00	$112.20
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $213.80 / $269.15	Professional	TC	$181.97	$213.80	$269.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $229.09 / $891.25	Professional		$123.03	$229.09	$891.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $89.13 / $416.87	Professional	26	$46.77	$89.13	$416.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $147.91 / $645.65	Professional	TC	$39.81	$147.91	$645.65
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 $223.87 / $331.13 / $478.63	Professional		$223.87	$331.13	$478.63
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $245.47 / $245.47	Facility	26	$100.00	$245.47	$245.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $588.84 / $891.25	Professional		$199.53	$588.84	$891.25
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $194.98 / $416.87	Professional	26	$58.88	$194.98	$416.87
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $407.38 / $645.65	Professional	TC	$138.04	$407.38	$645.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $831.76 / $1,000.00	Professional		$309.03	$831.76	$1,000.00
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $141.25 / $234.42	Professional	26	$131.83	$141.25	$234.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $190.55 / $426.58	Professional	TC	$162.18	$190.55	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $194.98 / $489.78	Professional		$95.50	$194.98	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $75.86 / $173.78	Professional	26	$42.66	$75.86	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $117.49 / $309.03	Professional	TC	$25.70	$117.49	$309.03