Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $27.76 / $49.50	Professional		$21.52	$27.76	$49.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $19.97 / $81.84	Professional	26	$16.30	$19.97	$81.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.62 / $6.51 / $16.38	Professional	TC	$5.62	$6.51	$16.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.53 / $83.80 / $168.59	Professional		$12.53	$83.80	$168.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $63.06 / $129.19	Professional	26	$9.36	$63.06	$129.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.17 / $20.54 / $39.40	Professional	TC	$3.17	$20.54	$39.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.05 / $19.88 / $33.52	Professional		$8.05	$19.88	$33.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $75.39 / $107.01	Facility	26	$66.34	$75.39	$107.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.12 / $38.96 / $94.61	Professional		$14.12	$38.96	$94.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $27.58 / $68.09	Professional	26	$10.48	$27.58	$68.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.01 / $11.38 / $23.89	Professional	TC	$4.01	$11.38	$23.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.38 / $95.38 / $95.38	Facility	26	$95.38	$95.38	$95.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.66 / $29.37 / $180.45	Professional		$20.66	$29.37	$180.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $22.47 / $134.87	Professional	26	$15.49	$22.47	$134.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $5.29 / $7.50 / $45.58	Professional	TC	$5.29	$7.50	$45.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.94 / $58.40 / $85.00	Professional		$9.94	$58.40	$85.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $68.65 / $99.83	Professional		$53.40	$68.65	$99.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $95.38	Facility	26	$40.92	$40.92	$95.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $150.56 / $180.45	Professional		$14.21	$150.56	$180.45
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $112.35 / $134.87	Professional	26	$10.67	$112.35	$134.87
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $3.98 / $45.58 / $56.46	Professional	TC	$3.98	$45.58	$56.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $22.49 / $81.16 / $152.66	Professional		$22.49	$81.16	$152.66
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $17.09 / $102.85	Professional	26	$17.09	$17.09	$102.85
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.41 / $5.41 / $25.75	Professional	TC	$5.41	$5.41	$25.75
United Facility/Professional Professional Modifier Low / Median / High Price $20.66 / $29.32 / $84.44	Professional		$20.66	$29.32	$84.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $22.47 / $73.03	Professional	26	$15.37	$22.47	$73.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.84 / $6.85 / $19.73	Professional	TC	$4.84	$6.85	$19.73