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 $70.79 / $104.71 / $302.00	Professional		$70.79	$104.71	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $61.66 / $186.21	Professional	26	$38.02	$61.66	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $75.86	Professional	TC	$24.55	$39.81	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $371.54	Professional		$67.61	$125.89	$371.54
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 $24.55 / $56.23 / $165.96	Professional	TC	$24.55	$56.23	$165.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $46.77 / $91.20	Professional		$39.81	$46.77	$91.20
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 $117.49 / $218.78 / $269.15	Professional		$117.49	$218.78	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $120.23 / $144.54	Professional	26	$61.66	$120.23	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $104.71 / $131.83	Professional	TC	$56.23	$104.71	$131.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $218.78	Professional		$144.54	$181.97	$218.78
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 $67.61 / $87.10 / $104.71	Professional	TC	$67.61	$87.10	$104.71
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $190.55 / $190.55	Facility	26	$95.50	$190.55	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $616.60	Professional		$75.86	$123.03	$616.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $79.43 / $263.03	Professional	26	$45.71	$79.43	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $44.67 / $263.03	Professional	TC	$27.54	$44.67	$263.03
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 $100.00 / $181.97 / $257.04	Professional		$100.00	$181.97	$257.04
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 $95.50 / $363.08 / $616.60	Professional		$95.50	$363.08	$616.60
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $213.80 / $263.03	Professional	26	$61.66	$213.80	$263.03
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $158.49 / $263.03	Professional	TC	$46.77	$158.49	$263.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $537.03	Professional		$218.78	$323.59	$537.03
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $177.83 / $218.78	Professional	26	$74.13	$177.83	$218.78
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $81.28 / $151.36	Professional	TC	$69.18	$81.28	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $245.47	Professional		$74.13	$112.20	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $144.54	Professional	26	$43.65	$67.61	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $43.65 / $97.72	Professional	TC	$26.30	$43.65	$97.72