Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $151.36	Facility	26	$79.43	$79.43	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $223.87	Professional		$74.13	$97.72	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $54.95 / $131.83	Professional	26	$38.90	$54.95	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $44.67 / $83.18	Professional	TC	$27.54	$44.67	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $131.83 / $398.11	Professional		$69.18	$131.83	$398.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $67.61 / $199.53	Professional	26	$42.66	$67.61	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $61.66 / $181.97	Professional	TC	$26.30	$61.66	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $125.89 / $199.53	Facility	26	$107.15	$125.89	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $229.09 / $281.84	Professional		$125.89	$229.09	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $120.23 / $144.54	Professional	26	$63.10	$120.23	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $117.49 / $144.54	Professional	TC	$63.10	$117.49	$144.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $229.09	Professional		$151.36	$190.55	$229.09
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $97.72 / $123.03	Professional	26	$74.13	$97.72	$123.03
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $97.72 / $117.49	Professional	TC	$74.13	$97.72	$117.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $204.17 / $204.17	Facility	26	$95.50	$204.17	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $676.08	Professional		$77.62	$131.83	$676.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $85.11 / $269.15	Professional	26	$46.77	$85.11	$269.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $50.12 / $288.40	Professional	TC	$30.20	$50.12	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $190.55 / $269.15	Professional		$107.15	$190.55	$269.15
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $263.03 / $263.03	Facility	26	$95.50	$263.03	$263.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $371.54 / $676.08	Professional		$102.33	$371.54	$676.08
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $213.80 / $269.15	Professional	26	$61.66	$213.80	$269.15
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $173.78 / $288.40	Professional	TC	$52.48	$173.78	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $575.44	Professional		$239.88	$354.81	$575.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $186.21 / $229.09	Professional	26	$158.49	$186.21	$229.09
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $165.96	Professional	TC	$79.43	$93.33	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $257.04	Professional		$77.62	$120.23	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $70.79 / $147.91	Professional	26	$43.65	$70.79	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $48.98 / $107.15	Professional	TC	$29.51	$48.98	$107.15