Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $83.18 / $123.03	Facility	26	$70.79	$83.18	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $281.84	Professional		$70.79	$89.13	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $47.86 / $186.21	Professional	26	$33.88	$47.86	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $42.66 / $81.28	Professional	TC	$23.44	$42.66	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $114.82 / $363.08	Professional		$64.57	$114.82	$363.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $61.66 / $177.83	Professional	26	$38.02	$61.66	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $61.66 / $177.83	Professional	TC	$25.12	$61.66	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $87.10	Professional		$39.81	$45.71	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $114.82 / $181.97	Facility	26	$97.72	$114.82	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $269.15	Professional		$117.49	$213.80	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $107.15 / $128.82	Professional	26	$56.23	$107.15	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $114.82 / $144.54	Professional	TC	$61.66	$114.82	$144.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $218.78	Professional		$141.25	$181.97	$218.78
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $85.11 / $109.65	Professional	26	$66.07	$85.11	$109.65
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $91.20 / $114.82	Professional	TC	$70.79	$91.20	$114.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $173.78 / $173.78	Facility	26	$85.11	$173.78	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $562.34	Professional		$72.44	$117.49	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $72.44 / $234.42	Professional	26	$41.69	$72.44	$234.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $48.98 / $288.40	Professional	TC	$27.54	$48.98	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $79.43	Professional		$32.36	$33.11	$79.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $251.19	Professional		$100.00	$181.97	$251.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $234.42 / $234.42	Facility	26	$85.11	$234.42	$234.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $346.74 / $562.34	Professional		$91.20	$346.74	$562.34
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $190.55 / $234.42	Professional	26	$54.95	$190.55	$234.42
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $173.78 / $288.40	Professional	TC	$50.12	$173.78	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $302.00 / $537.03	Professional		$102.33	$302.00	$537.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $158.49 / $194.98	Professional	26	$64.57	$158.49	$194.98
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $165.96	Professional	TC	$67.61	$79.43	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $234.42	Professional		$70.79	$109.65	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $131.83	Professional	26	$39.81	$61.66	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $45.71 / $102.33	Professional	TC	$25.70	$45.71	$102.33