Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $25.12 / $100.00	Professional		$12.88	$25.12	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $9.55 / $50.12	Professional	26	$3.02	$9.55	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $12.88 / $26.30	Professional	TC	$8.91	$12.88	$26.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $39.81 / $104.71	Professional		$16.98	$39.81	$104.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $10.00 / $30.20	Professional	26	$4.68	$10.00	$30.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $27.54 / $74.13	Professional	TC	$12.30	$27.54	$74.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.90 / $13.80 / $20.42	Facility		$4.90	$13.80	$20.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.89 / $12.30 / $25.12	Professional		$3.89	$12.30	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $57.54 / $85.11	Facility		$50.12	$57.54	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $14.45 / $21.38	Facility	26	$12.59	$14.45	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $21.88 / $48.98	Professional		$7.59	$21.88	$48.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.09 / $5.75 / $12.59	Professional	26	$2.09	$5.75	$12.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.62 / $16.98 / $34.67	Professional	TC	$5.62	$16.98	$34.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $26.92 / $63.10	Facility		$13.80	$26.92	$63.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $48.98	Professional		$44.67	$44.67	$48.98
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.22 / $12.59	Professional	26	$11.22	$11.22	$12.59
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $37.15	Professional	TC	$33.11	$33.11	$37.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $20.89 / $66.07	Facility		$13.80	$20.89	$66.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $25.70 / $123.03	Professional		$11.75	$25.70	$123.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $9.33 / $87.10	Professional	26	$3.39	$9.33	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $19.05 / $97.72	Professional	TC	$8.32	$19.05	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $58.88 / $85.11	Professional		$29.51	$58.88	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $97.72	Professional		$28.18	$40.74	$97.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $100.00	Facility		$35.48	$35.48	$100.00
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $112.20 / $125.89	Professional		$7.59	$112.20	$125.89
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $1.95 / $33.88 / $87.10	Professional	26	$1.95	$33.88	$87.10
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $5.62 / $91.20 / $100.00	Professional	TC	$5.62	$91.20	$100.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $83.18	Professional		$38.02	$50.12	$83.18
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $6.92 / $20.89	Professional	26	$6.92	$6.92	$20.89
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $9.33 / $39.81	Professional	TC	$9.33	$9.33	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.49 / $47.86	Professional		$10.96	$15.49	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $4.37 / $10.72	Professional	26	$2.82	$4.37	$10.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $7.08 / $11.22 / $36.31	Professional	TC	$7.08	$11.22	$36.31