Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.27 / $28.27 / $54.26	Facility	26	$28.27	$28.27	$54.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $53.55 / $89.01	Professional		$28.39	$53.55	$89.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.51 / $19.22 / $81.92	Professional	26	$14.51	$19.22	$81.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.01 / $35.83 / $60.74	Professional	TC	$13.01	$35.83	$60.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $65.87 / $238.83	Professional		$34.17	$65.87	$238.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.66 / $26.79 / $89.66	Professional	26	$14.66	$26.79	$89.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $44.94 / $139.69	Professional	TC	$19.09	$44.94	$139.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.85 / $44.23 / $67.84	Facility	26	$37.85	$44.23	$67.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.72 / $129.84 / $147.55	Professional		$66.72	$129.84	$147.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.07 / $42.01 / $47.74	Professional	26	$22.07	$42.01	$47.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.81 / $87.82 / $99.80	Professional	TC	$44.81	$87.82	$99.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.90 / $80.00 / $80.00	Facility	26	$33.90	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.56 / $60.28 / $306.10	Professional		$34.56	$60.28	$306.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.09 / $93.99	Professional	26	$16.22	$27.09	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $15.36 / $36.36 / $212.11	Professional	TC	$15.36	$36.36	$212.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $37.91 / $72.52	Professional		$19.36	$37.91	$72.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.02 / $104.91 / $143.88	Professional		$52.02	$104.91	$143.88
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $19.35 / $33.90 / $80.00	Facility	26	$19.35	$33.90	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $195.70 / $306.10	Professional		$75.28	$195.70	$306.10
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $24.36 / $77.00 / $93.99	Professional	26	$24.36	$77.00	$93.99
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $47.14 / $130.94 / $212.11	Professional	TC	$47.14	$130.94	$212.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $99.42 / $215.64 / $307.64	Professional		$99.42	$215.64	$307.64
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.25 / $62.65 / $77.91	Professional	26	$53.25	$62.65	$77.91
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $47.82 / $147.26	Professional	TC	$40.65	$47.82	$147.26
United Facility/Professional Professional Modifier Low / Median / High Price $36.51 / $64.58 / $128.65	Professional		$36.51	$64.58	$128.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.81 / $51.48	Professional	26	$16.22	$27.81	$51.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.36 / $36.56 / $78.03	Professional	TC	$15.36	$36.56	$78.03