Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $165.96	Professional		$52.48	$67.61	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.55 / $77.62	Professional	26	$19.95	$24.55	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $97.72	Professional	TC	$31.62	$44.67	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $131.83 / $389.05	Professional		$26.92	$131.83	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $56.23 / $154.88	Professional	26	$10.47	$56.23	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $93.33 / $234.42	Professional	TC	$16.60	$93.33	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $87.10 / $128.82	Facility	26	$77.62	$87.10	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $107.15 / $234.42	Professional		$33.11	$107.15	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $32.36 / $75.86	Professional	26	$11.75	$32.36	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $74.13 / $162.18	Professional	TC	$19.95	$74.13	$162.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $251.19	Professional		$229.09	$229.09	$251.19
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $75.86	Professional	26	$67.61	$67.61	$75.86
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $177.83	Professional	TC	$158.49	$158.49	$177.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	26	$112.20	$112.20	$112.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $91.20 / $467.74	Professional		$47.86	$91.20	$467.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $35.48 / $186.21	Professional	26	$17.78	$35.48	$186.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $54.95 / $309.03	Professional	TC	$26.92	$54.95	$309.03
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 $114.82 / $194.98 / $275.42	Professional		$114.82	$194.98	$275.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $154.88	Facility	26	$100.00	$100.00	$154.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $331.13 / $467.74	Professional		$36.31	$331.13	$467.74
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $128.82 / $186.21	Professional	26	$11.75	$128.82	$186.21
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $218.78 / $309.03	Professional	TC	$21.88	$218.78	$309.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $120.23 / $416.87	Professional		$109.65	$120.23	$416.87
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.05 / $91.20	Professional	26	$19.05	$19.05	$91.20
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $138.04	Professional	TC	$28.84	$28.84	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $154.88	Professional		$41.69	$66.07	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.70 / $66.07	Professional	26	$15.85	$25.70	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $100.00	Professional	TC	$25.12	$40.74	$100.00