Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $19.21 / $56.17	Professional		$14.80	$19.21	$56.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $14.14 / $119.66	Professional	26	$9.09	$14.14	$119.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.81 / $7.89 / $17.85	Professional	TC	$5.81	$7.89	$17.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.07 / $57.69 / $120.09	Professional		$9.07	$57.69	$120.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.33 / $35.29 / $72.14	Professional	26	$5.33	$35.29	$72.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.74 / $23.12 / $47.95	Professional	TC	$3.74	$23.12	$47.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.54 / $11.28 / $22.57	Facility		$7.54	$11.28	$22.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.54 / $12.41 / $22.57	Professional		$7.54	$12.41	$22.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.18 / $71.80 / $101.91	Facility		$63.18	$71.80	$101.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.79 / $40.69 / $57.75	Facility	26	$35.79	$40.69	$57.75
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.38 / $31.11 / $44.16	Facility	TC	$27.38	$31.11	$44.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.74 / $27.72 / $64.43	Professional		$9.74	$27.72	$64.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.05 / $16.35 / $37.54	Professional	26	$6.05	$16.35	$37.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.77 / $11.55 / $26.85	Professional	TC	$3.77	$11.55	$26.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.84 / $23.54 / $69.45	Facility		$17.84	$23.54	$69.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.84 / $25.39 / $100.00	Facility		$17.84	$25.39	$100.00
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.26 / $28.81 / $130.47	Professional		$15.26	$28.81	$130.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $26.86 / $95.76	Professional	26	$9.50	$26.86	$95.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $6.05 / $10.16 / $95.76	Professional	TC	$6.05	$10.16	$95.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.64 / $41.09 / $70.17	Professional		$5.64	$41.09	$70.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.84 / $23.54 / $69.45	Facility		$17.84	$23.54	$69.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $48.12 / $68.42	Professional		$36.60	$48.12	$68.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $38.72 / $38.72 / $100.00	Facility		$38.72	$38.72	$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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.93 / $104.40 / $130.47	Professional		$10.93	$104.40	$130.47
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $6.40 / $62.75 / $95.76	Professional	26	$6.40	$62.75	$95.76
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $4.04 / $41.70 / $95.76	Professional	TC	$4.04	$41.70	$95.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $32.75 / $32.75 / $103.96	Professional		$32.75	$32.75	$103.96
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $9.67 / $46.08	Professional	26	$9.67	$9.67	$46.08
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.48 / $7.48 / $31.24	Professional	TC	$7.48	$7.48	$31.24
United Facility/Professional Professional Modifier Low / Median / High Price $14.76 / $20.88 / $60.13	Professional		$14.76	$20.88	$60.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $12.42 / $36.14	Professional	26	$8.07	$12.42	$36.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $5.41 / $8.24 / $22.12	Professional	TC	$5.41	$8.24	$22.12