Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $30.67 / $30.67	Facility		$30.67	$30.67	$30.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.81 / $14.81 / $14.81	Facility	26	$14.81	$14.81	$14.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $40.00 / $66.04	Professional		$27.43	$40.00	$66.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.43 / $15.69 / $47.12	Professional	26	$13.43	$15.69	$47.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.00 / $19.69 / $37.11	Professional	TC	$14.00	$19.69	$37.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $63.90 / $107.44	Professional		$33.14	$63.90	$107.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.11 / $30.85 / $51.97	Professional	26	$16.11	$30.85	$51.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.02 / $33.04 / $55.46	Professional	TC	$17.02	$33.04	$55.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $104.25 / $118.47	Facility		$89.21	$104.25	$118.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.45 / $48.44 / $55.04	Facility	26	$41.45	$48.44	$55.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.94 / $66.87 / $86.98	Professional		$36.94	$66.87	$86.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $31.87 / $38.81	Professional	26	$17.32	$31.87	$38.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $35.00 / $44.16	Professional	TC	$19.64	$35.00	$44.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.24 / $37.15 / $69.75	Facility		$27.24	$37.15	$69.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.32 / $37.15 / $98.62	Facility		$26.32	$37.15	$98.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $36.40 / $100.00 / $100.00	Facility	26	$36.40	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $47.33 / $138.60	Professional		$32.29	$47.33	$138.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.94 / $20.91 / $63.52	Professional	26	$14.94	$20.91	$63.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.21 / $26.30 / $69.03	Professional	TC	$16.21	$26.30	$69.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $53.04 / $71.19	Professional		$21.28	$53.04	$71.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.24 / $37.15 / $69.75	Facility		$27.24	$37.15	$69.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $76.33 / $108.18	Professional		$28.57	$76.33	$108.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $98.62 / $171.87	Facility		$67.20	$98.62	$171.87
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $32.03 / $36.40 / $100.00	Facility	26	$32.03	$36.40	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $194.67 / $354.38	Professional		$59.40	$194.67	$354.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $80.40 / $98.32	Professional	26	$29.27	$80.40	$98.32
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $121.25 / $180.44	Professional	TC	$30.14	$121.25	$180.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $117.37 / $117.37	Professional		$52.58	$117.37	$117.37
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.09 / $37.97 / $48.86	Professional	26	$25.09	$37.97	$48.86
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.52 / $26.49 / $50.47	Professional	TC	$22.52	$26.49	$50.47
United Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $45.21 / $76.17	Professional		$30.97	$45.21	$76.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $20.00 / $37.06	Professional	26	$14.76	$20.00	$37.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.21 / $24.01 / $43.05	Professional	TC	$16.21	$24.01	$43.05