Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $45.71 / $85.11	Facility	26	$38.90	$45.71	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $363.08	Professional		$91.20	$131.83	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $56.23 / $181.97	Professional	26	$25.12	$56.23	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $87.10 / $165.96	Professional	TC	$64.57	$87.10	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $549.54	Professional		$53.70	$53.70	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $151.36	Professional	26	$14.79	$14.79	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $38.90 / $426.58	Professional	TC	$38.90	$38.90	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $102.33 / $165.96	Facility	26	$89.13	$102.33	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $199.53 / $436.52	Professional		$60.26	$199.53	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $52.48 / $109.65	Professional	26	$15.49	$52.48	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $158.49 / $323.59	Professional	TC	$44.67	$158.49	$323.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $389.05	Professional		$346.74	$346.74	$389.05
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $100.00	Professional	26	$89.13	$89.13	$100.00
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $263.03 / $288.40	Professional	TC	$263.03	$263.03	$288.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $870.96	Professional		$87.10	$134.90	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $35.48 / $213.80	Professional	26	$24.55	$35.48	$213.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $97.72 / $660.69	Professional	TC	$63.10	$97.72	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $204.17	Professional		$32.36	$54.95	$204.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $416.87	Professional		$186.21	$302.00	$416.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $213.80 / $213.80	Facility	26	$102.33	$213.80	$213.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $407.38 / $870.96	Professional		$54.95	$407.38	$870.96
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $102.33 / $213.80	Professional	26	$14.13	$102.33	$213.80
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $309.03 / $660.69	Professional	TC	$41.69	$309.03	$660.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $331.13 / $691.83	Professional		$95.50	$331.13	$691.83
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $104.71	Professional	26	$26.92	$26.92	$104.71
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $69.18 / $302.00	Professional	TC	$69.18	$69.18	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $281.84	Professional		$79.43	$128.82	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $34.67 / $75.86	Professional	26	$19.95	$34.67	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $199.53	Professional	TC	$60.26	$95.50	$199.53