Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $18.19 / $134.90	Professional		$11.34	$18.19	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.38 / $4.93 / $65.09	Professional	26	$3.38	$4.93	$65.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.19 / $13.26 / $23.21	Professional	TC	$8.19	$13.26	$23.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.92 / $46.96 / $93.84	Professional		$16.92	$46.96	$93.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $12.52 / $27.24	Professional	26	$4.68	$12.52	$27.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.24 / $35.31 / $67.20	Professional	TC	$12.24	$35.31	$67.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.93 / $11.25 / $18.22	Facility		$3.93	$11.25	$18.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.93 / $11.25 / $18.22	Professional		$3.93	$11.25	$18.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.55 / $57.44 / $81.53	Facility		$50.55	$57.44	$81.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.64 / $14.36 / $20.38	Facility	26	$12.64	$14.36	$20.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $22.64 / $49.02	Professional		$7.59	$22.64	$49.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.10 / $6.19 / $13.48	Professional	26	$2.10	$6.19	$13.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.63 / $17.09 / $34.50	Professional	TC	$5.63	$17.09	$34.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.79 / $20.79 / $62.79	Facility		$13.79	$20.79	$62.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.79 / $20.79 / $65.48	Facility		$13.79	$20.79	$65.48
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 $11.81 / $25.50 / $122.00	Professional		$11.81	$25.50	$122.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $3.41 / $8.59 / $87.52	Professional	26	$3.41	$8.59	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $8.31 / $18.13 / $97.85	Professional	TC	$8.31	$18.13	$97.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.63 / $41.71 / $70.00	Professional		$5.63	$41.71	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.79 / $20.79 / $62.79	Facility		$13.79	$20.79	$62.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $39.44 / $98.81	Professional		$30.00	$39.44	$98.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35.56 / $35.56 / $100.00	Facility		$35.56	$35.56	$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 $8.10 / $112.56 / $122.00	Professional		$8.10	$112.56	$122.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $2.31 / $33.88 / $87.52	Professional	26	$2.31	$33.88	$87.52
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $5.63 / $91.97 / $97.85	Professional	TC	$5.63	$91.97	$97.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $45.19 / $82.23	Professional		$38.11	$45.19	$82.23
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $6.95 / $20.99	Professional	26	$6.95	$6.95	$20.99
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.35 / $9.35 / $39.82	Professional	TC	$9.35	$9.35	$39.82
United Facility/Professional Professional Modifier Low / Median / High Price $11.81 / $14.76 / $47.97	Professional		$11.81	$14.76	$47.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.15 / $4.37 / $13.66	Professional	26	$3.15	$4.37	$13.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.31 / $10.54 / $36.76	Professional	TC	$8.31	$10.54	$36.76