Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $173.78	Professional		$52.48	$67.61	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $63.10	Professional	26	$20.89	$22.91	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $44.67 / $104.71	Professional	TC	$30.90	$44.67	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $144.54 / $426.58	Professional		$29.51	$144.54	$426.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $58.88 / $162.18	Professional	26	$10.96	$58.88	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $100.00 / $263.03	Professional	TC	$18.62	$100.00	$263.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $89.13 / $131.83	Facility	26	$77.62	$89.13	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $104.71 / $229.09	Professional		$33.88	$104.71	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $33.11 / $75.86	Professional	26	$11.75	$33.11	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $74.13 / $154.88	Professional	TC	$21.38	$74.13	$154.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $251.19	Professional		$223.87	$223.87	$251.19
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $75.86	Professional	26	$69.18	$69.18	$75.86
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $173.78	Professional	TC	$158.49	$158.49	$173.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $95.50 / $457.09	Professional		$46.77	$95.50	$457.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $36.31 / $158.49	Professional	26	$18.20	$36.31	$158.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $51.29 / $302.00	Professional	TC	$27.54	$51.29	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $85.11	Professional		$32.36	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $190.55 / $269.15	Professional		$104.71	$190.55	$269.15
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $158.49	Facility	26	$100.00	$100.00	$158.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $346.74 / $457.09	Professional		$35.48	$346.74	$457.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $131.83 / $158.49	Professional	26	$11.75	$131.83	$158.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $213.80 / $302.00	Professional	TC	$21.38	$213.80	$302.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $199.53 / $407.38	Professional		$44.67	$199.53	$407.38
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $95.50	Professional	26	$19.95	$19.95	$95.50
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $158.49	Professional	TC	$33.11	$33.11	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $69.18 / $158.49	Professional		$41.69	$69.18	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $26.30 / $64.57	Professional	26	$16.22	$26.30	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $104.71	Professional	TC	$25.70	$42.66	$104.71