Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.63 / $37.61 / $139.78	Professional		$24.63	$37.61	$139.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.19 / $7.73 / $117.80	Professional	26	$5.19	$7.73	$117.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $29.87 / $65.92	Professional	TC	$18.39	$29.87	$65.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $99.06 / $196.58	Professional		$31.68	$99.06	$196.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $19.67 / $43.61	Professional	26	$7.56	$19.67	$43.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $81.30 / $153.16	Professional	TC	$24.12	$81.30	$153.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.17 / $24.56 / $36.88	Facility		$6.17	$24.56	$36.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $24.56 / $36.88	Professional		$6.17	$24.56	$36.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.30 / $119.66 / $169.85	Facility		$105.30	$119.66	$169.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.01 / $22.74 / $32.27	Facility	26	$20.01	$22.74	$32.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.37 / $45.60 / $98.23	Professional		$15.37	$45.60	$98.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.31 / $9.27 / $21.13	Professional	26	$3.31	$9.27	$21.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.28 / $37.42 / $76.91	Professional	TC	$12.28	$37.42	$76.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.83 / $45.05 / $136.33	Facility		$27.83	$45.05	$136.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.83 / $45.05 / $145.86	Facility		$27.83	$45.05	$145.86
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 $23.66 / $51.00 / $263.07	Professional		$23.66	$51.00	$263.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $5.49 / $19.76 / $145.30	Professional	26	$5.49	$19.76	$145.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $43.78 / $226.21	Professional	TC	$18.17	$43.78	$226.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.72 / $58.40 / $88.79	Professional		$11.72	$58.40	$88.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.83 / $45.05 / $136.33	Facility		$27.83	$45.05	$136.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $78.88 / $208.67	Professional		$60.00	$78.88	$208.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.45 / $74.45 / $162.36	Facility		$74.45	$74.45	$162.36
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 $16.78 / $232.21 / $263.07	Professional		$16.78	$232.21	$263.07
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $73.40 / $145.30	Professional	26	$3.55	$73.40	$145.30
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $12.64 / $200.73 / $226.21	Professional	TC	$12.64	$200.73	$226.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $86.30 / $169.86	Professional		$74.68	$86.30	$169.86
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $72.91 / $72.91	Professional	26	$21.03	$72.91	$72.91
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.69 / $18.69 / $80.30	Professional	TC	$18.69	$18.69	$80.30
United Facility/Professional Professional Modifier Low / Median / High Price $23.66 / $30.73 / $108.27	Professional		$23.66	$30.73	$108.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $6.86 / $22.30	Professional	26	$5.13	$6.86	$22.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $23.05 / $84.97	Professional	TC	$18.17	$23.05	$84.97