Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.42 / $31.81 / $51.52	Professional		$27.42	$31.81	$51.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.12 / $26.86 / $39.08	Professional	26	$16.12	$26.86	$39.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.17 / $15.79 / $25.76	Professional	52	$13.17	$15.79	$25.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.60 / $4.46 / $29.78	Professional	TC	$3.60	$4.46	$29.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $56.98 / $126.19	Professional		$28.08	$56.98	$126.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $49.07 / $110.94	Professional	26	$24.89	$49.07	$110.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.48 / $7.94 / $17.73	Professional	TC	$3.48	$7.94	$17.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.78 / $76.87 / $87.35	Facility	26	$65.78	$76.87	$87.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $62.90 / $84.24	Professional		$31.74	$62.90	$84.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $55.51 / $73.33	Professional	26	$26.09	$55.51	$73.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.24 / $8.23 / $11.88	Professional	TC	$4.24	$8.23	$11.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.67 / $112.04 / $112.04	Facility	26	$57.67	$112.04	$112.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.33 / $49.19 / $138.05	Professional		$27.33	$49.19	$138.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $34.00 / $104.49	Professional	26	$18.30	$34.00	$104.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.51 / $7.62 / $62.44	Professional	TC	$3.51	$7.62	$62.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.83 / $65.00 / $98.30	Professional		$11.83	$65.00	$98.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $68.11 / $267.97	Professional		$35.67	$68.11	$267.97
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $50.71 / $57.67 / $112.04	Facility	26	$50.71	$57.67	$112.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.24 / $198.11 / $303.81	Professional		$36.24	$198.11	$303.81
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $31.09 / $126.60 / $156.38	Professional	26	$31.09	$126.60	$156.38
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $5.15 / $131.11 / $211.93	Professional	TC	$5.15	$131.11	$211.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.15 / $148.62 / $148.62	Professional		$69.15	$148.62	$148.62
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.29 / $53.25 / $62.69	Professional	26	$31.29	$53.25	$62.69
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.11 / $5.84 / $16.20	Professional	TC	$5.11	$5.84	$16.20
United Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $46.02 / $95.98	Professional		$27.29	$46.02	$95.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.29 / $37.61 / $83.23	Professional	26	$19.29	$37.61	$83.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.51 / $6.68 / $17.14	Professional	TC	$3.51	$6.68	$17.14