Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.33 / $13.02 / $38.86	Facility	26	$11.33	$13.02	$38.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $51.00 / $213.07	Professional		$32.72	$51.00	$213.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $16.16 / $114.75	Professional	26	$11.03	$16.16	$114.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $22.60 / $37.39	Professional	TC	$19.76	$22.60	$37.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $64.09 / $150.91	Professional		$34.11	$64.09	$150.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.55 / $24.06 / $53.58	Professional	26	$12.55	$24.06	$53.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $40.03 / $95.99	Professional	TC	$21.75	$40.03	$95.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.07 / $22.14 / $37.13	Professional		$11.07	$22.14	$37.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.03 / $31.59 / $41.99	Facility	26	$27.03	$31.59	$41.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $77.62 / $88.20	Professional		$36.40	$77.62	$88.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.47 / $26.51 / $31.85	Professional	26	$13.47	$26.51	$31.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $51.11 / $58.08	Professional	TC	$22.16	$51.11	$58.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $81.73 / $195.66	Professional		$44.52	$81.73	$195.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.72 / $32.54 / $69.84	Professional	26	$17.72	$32.54	$69.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.65 / $51.33 / $129.61	Professional	TC	$26.65	$51.33	$129.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $43.66 / $71.18	Professional		$19.71	$43.66	$71.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $72.06 / $112.49	Professional		$59.15	$72.06	$112.49
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $24.93 / $70.00 / $70.00	Facility	26	$24.93	$70.00	$70.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $180.05 / $195.66	Professional		$38.53	$180.05	$195.66
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $69.84 / $69.84	Professional	26	$13.16	$69.84	$69.84
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $110.20 / $129.61	Professional	TC	$25.09	$110.20	$129.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $156.81 / $156.81	Professional		$80.59	$156.81	$156.81
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.52 / $31.04 / $42.88	Professional	26	$24.52	$31.04	$42.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.48 / $60.32 / $76.31	Professional	TC	$46.48	$60.32	$76.31
United Facility/Professional Professional Modifier Low / Median / High Price $41.06 / $73.65 / $135.04	Professional		$41.06	$73.65	$135.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.76 / $28.57 / $52.39	Professional	26	$16.76	$28.57	$52.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.87 / $45.62 / $85.09	Professional	TC	$25.87	$45.62	$85.09