Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $52.11 / $114.13	Professional		$34.84	$52.11	$114.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.40 / $28.31 / $198.10	Professional	26	$22.40	$28.31	$198.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.88 / $18.23 / $36.04	Professional	TC	$9.88	$18.23	$36.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $138.04 / $306.98	Professional		$21.74	$138.04	$306.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $87.86 / $182.20	Professional	26	$13.10	$87.86	$182.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.64 / $50.04 / $118.91	Professional	TC	$8.64	$50.04	$118.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.70 / $196.25 / $278.55	Facility		$172.70	$196.25	$278.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.67 / $105.30 / $149.47	Facility	26	$92.67	$105.30	$149.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $74.06 / $174.21	Professional		$25.59	$74.06	$174.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.73 / $41.11 / $95.41	Professional	26	$14.73	$41.11	$95.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.89 / $33.94 / $72.95	Professional	TC	$9.89	$33.94	$72.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.15 / $63.65 / $153.54	Facility		$47.15	$63.65	$153.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.15 / $69.09 / $159.09	Facility		$47.15	$69.09	$159.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.74 / $134.74 / $134.74	Facility	26	$134.74	$134.74	$134.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $63.00 / $342.09	Professional		$36.65	$63.00	$342.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.35 / $43.72 / $250.96	Professional	26	$23.35	$43.72	$250.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.55 / $21.70 / $250.96	Professional	TC	$10.55	$21.70	$250.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.09 / $65.00 / $104.44	Professional		$14.09	$65.00	$104.44
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $47.15 / $63.65 / $153.54	Facility		$47.15	$63.65	$153.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $126.49 / $183.96	Professional		$87.89	$126.49	$183.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $104.70 / $104.70 / $248.27	Facility		$104.70	$104.70	$248.27
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $134.74	Facility	26	$100.00	$100.00	$134.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.53 / $266.89 / $342.09	Professional		$28.53	$266.89	$342.09
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.67 / $158.40 / $250.96	Professional	26	$15.67	$158.40	$250.96
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $11.84 / $108.45 / $250.96	Professional	TC	$11.84	$108.45	$250.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $107.40 / $148.72 / $281.19	Professional		$107.40	$148.72	$281.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.69 / $61.69 / $114.28	Professional	26	$61.69	$61.69	$114.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $65.23	Professional	TC	$14.79	$14.79	$65.23
United Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $53.38 / $153.72	Professional		$36.54	$53.38	$153.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.87 / $66.20 / $152.38	Professional	26	$27.87	$66.20	$152.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.85 / $21.70 / $70.53	Professional	TC	$10.85	$21.70	$70.53