Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $52.48 / $186.21	Professional		$26.92	$52.48	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $24.55 / $69.18	Professional	26	$6.03	$24.55	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $66.07	Professional	TC	$19.95	$28.84	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $87.10 / $213.80	Professional		$31.62	$87.10	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $15.49 / $47.86	Professional	26	$7.59	$15.49	$47.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $66.07 / $162.18	Professional	TC	$23.99	$66.07	$162.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $30.20 / $41.69	Facility		$7.59	$30.20	$41.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $26.92 / $53.70	Professional		$6.17	$26.92	$53.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $177.83	Facility		$104.71	$120.23	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.91 / $33.88	Facility	26	$19.95	$22.91	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $45.71 / $97.72	Professional		$15.49	$45.71	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $8.71 / $21.38	Professional	26	$3.16	$8.71	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $36.31 / $77.62	Professional	TC	$12.30	$36.31	$77.62
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $44.67 / $134.90	Facility		$27.54	$44.67	$134.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $100.00	Professional		$89.13	$89.13	$100.00
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $17.78 / $19.95	Professional	26	$17.78	$17.78	$19.95
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $79.43	Professional	TC	$72.44	$72.44	$79.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $44.67 / $144.54	Facility		$27.54	$44.67	$144.54
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 $23.44 / $52.48 / $263.03	Professional		$23.44	$52.48	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $19.95 / $144.54	Professional	26	$5.50	$19.95	$144.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $43.65 / $223.87	Professional	TC	$19.05	$43.65	$223.87
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 $56.23 / $81.28 / $208.93	Professional		$56.23	$81.28	$208.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $199.53	Facility		$74.13	$74.13	$199.53
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 $15.49 / $234.42 / $269.15	Professional		$15.49	$234.42	$269.15
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $74.13 / $144.54	Professional	26	$3.09	$74.13	$144.54
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $199.53 / $234.42	Professional	TC	$12.30	$199.53	$234.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $169.82	Professional		$74.13	$100.00	$169.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $72.44 / $72.44	Professional	26	$20.89	$72.44	$72.44
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $18.62 / $79.43	Professional	TC	$18.62	$18.62	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $95.50	Professional		$20.89	$30.90	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $6.92 / $18.62	Professional	26	$4.37	$6.92	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $24.55 / $81.28	Professional	TC	$15.85	$24.55	$81.28