Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.87 / $22.87 / $22.87	Facility	26	$22.87	$22.87	$22.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $27.69 / $52.04	Professional		$23.82	$27.69	$52.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $22.71 / $32.72	Professional	26	$19.04	$22.71	$32.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.83 / $4.68 / $28.32	Professional	TC	$3.83	$4.68	$28.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.42 / $52.63 / $105.79	Professional		$24.42	$52.63	$105.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $43.42 / $92.63	Professional	26	$20.88	$43.42	$92.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.65 / $7.94 / $18.04	Professional	TC	$3.65	$7.94	$18.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.87 / $65.29 / $74.19	Facility	26	$55.87	$65.29	$74.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $54.76 / $73.33	Professional		$27.78	$54.76	$73.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $47.62 / $61.44	Professional	26	$22.69	$47.62	$61.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.62 / $8.85 / $11.94	Professional	TC	$4.62	$8.85	$11.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.22 / $100.00 / $100.00	Facility	26	$48.22	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $43.72 / $117.91	Professional		$23.62	$43.72	$117.91
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $29.93 / $98.35	Professional	26	$19.55	$29.93	$98.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.82 / $7.60 / $53.67	Professional	TC	$3.82	$7.60	$53.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $65.00 / $85.09	Professional		$13.00	$65.00	$85.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $59.40 / $221.35	Professional		$31.11	$59.40	$221.35
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $42.42 / $48.22 / $100.00	Facility	26	$42.42	$48.22	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.50 / $194.31 / $313.77	Professional		$31.50	$194.31	$313.77
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $105.30 / $156.85	Professional	26	$26.35	$105.30	$156.85
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $5.15 / $114.24 / $220.13	Professional	TC	$5.15	$114.24	$220.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.47 / $129.18 / $129.18	Professional		$61.47	$129.18	$129.18
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $47.92 / $62.04	Professional	26	$26.09	$47.92	$62.04
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.53 / $7.41 / $16.20	Professional	TC	$5.53	$7.41	$16.20
United Facility/Professional Professional Modifier Low / Median / High Price $23.37 / $39.20 / $83.38	Professional		$23.37	$39.20	$83.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.48 / $28.56 / $69.23	Professional	26	$19.48	$28.56	$69.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.68 / $5.98 / $16.32	Professional	TC	$3.68	$5.98	$16.32