Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.10 / $8.10 / $8.10	Facility	26	$8.10	$8.10	$8.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $51.65 / $85.39	Professional		$43.93	$51.65	$85.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $9.15 / $14.12	Professional	26	$7.38	$9.15	$14.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.54 / $44.56 / $70.54	Professional	TC	$36.54	$44.56	$70.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.25 / $87.86 / $173.28	Professional		$52.25	$87.86	$173.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $15.51 / $29.66	Professional	26	$9.01	$15.51	$29.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.24 / $73.51 / $143.83	Professional	TC	$43.24	$73.51	$143.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.59 / $33.59 / $40.76	Facility	26	$33.59	$33.59	$40.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $100.58 / $130.41	Professional		$43.34	$100.58	$130.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $16.16 / $20.54	Professional	26	$6.92	$16.16	$20.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.42 / $84.41 / $108.88	Professional	TC	$36.42	$84.41	$108.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $67.20 / $343.33	Professional		$40.22	$67.20	$343.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.73 / $166.76	Professional	26	$8.27	$11.73	$166.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.54 / $55.48 / $288.04	Professional	TC	$31.54	$55.48	$288.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $31.53 / $71.18	Professional		$19.71	$31.53	$71.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $121.53 / $176.33	Professional		$60.31	$121.53	$176.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.51 / $254.45 / $343.33	Professional		$60.51	$254.45	$343.33
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $63.49 / $166.76	Professional	26	$9.94	$63.49	$166.76
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $50.56 / $209.50 / $288.04	Professional	TC	$50.56	$209.50	$288.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.90 / $183.28 / $190.61	Professional		$83.90	$183.28	$190.61
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.40 / $14.21 / $26.48	Professional	26	$12.40	$14.21	$26.48
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.37 / $69.84 / $133.06	Professional	TC	$59.37	$69.84	$133.06
United Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $65.11 / $121.34	Professional		$46.80	$65.11	$121.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $11.73 / $23.37	Professional	26	$8.08	$11.73	$23.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $55.48 / $104.75	Professional	TC	$38.22	$55.48	$104.75