Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $100.00	Professional		$51.29	$64.57	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $35.48	Professional	26	$18.20	$22.91	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $63.10	Professional	TC	$32.36	$41.69	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $162.18 / $436.52	Professional		$32.36	$162.18	$436.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $58.88 / $162.18	Professional	26	$11.48	$58.88	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $120.23 / $275.42	Professional	TC	$20.42	$120.23	$275.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $87.10 / $128.82	Facility	26	$77.62	$87.10	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $87.10 / $204.17	Professional		$30.90	$87.10	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $32.36 / $75.86	Professional	26	$11.75	$32.36	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $56.23 / $128.82	Professional	TC	$19.05	$56.23	$128.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $199.53	Professional		$177.83	$177.83	$199.53
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $74.13	Professional	26	$67.61	$67.61	$74.13
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $112.20 / $123.03	Professional	TC	$112.20	$112.20	$123.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $436.52	Professional		$52.48	$72.44	$436.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.92 / $158.49	Professional	26	$18.20	$26.92	$158.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $44.67 / $281.84	Professional	TC	$34.67	$44.67	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $117.49	Professional		$32.36	$64.57	$117.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $218.78	Professional		$109.65	$151.36	$218.78
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $158.49	Facility	26	$54.95	$54.95	$158.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $239.88 / $436.52	Professional		$30.90	$239.88	$436.52
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $91.20 / $158.49	Professional	26	$11.75	$91.20	$158.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $147.91 / $281.84	Professional	TC	$19.05	$147.91	$281.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $223.87 / $389.05	Professional		$57.54	$223.87	$389.05
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.38 / $81.28	Professional	26	$21.38	$21.38	$81.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $141.25	Professional	TC	$37.15	$37.15	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $72.44 / $173.78	Professional		$44.67	$72.44	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.92 / $61.66	Professional	26	$16.60	$26.92	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $109.65	Professional	TC	$28.18	$44.67	$109.65