Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $75.86	Facility	26	$38.90	$38.90	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $63.10 / $120.23	Professional		$42.66	$63.10	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $25.12 / $64.57	Professional	26	$18.62	$25.12	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $37.15 / $69.18	Professional	TC	$19.05	$37.15	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $81.28 / $257.04	Professional		$43.65	$81.28	$257.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $97.72	Professional	26	$20.89	$33.88	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $51.29 / $147.91	Professional	TC	$21.88	$51.29	$147.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $61.66 / $100.00	Facility	26	$53.70	$61.66	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $151.36 / $190.55	Professional		$83.18	$151.36	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $58.88 / $70.79	Professional	26	$30.90	$58.88	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $97.72 / $123.03	Professional	TC	$51.29	$97.72	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $154.88	Professional		$102.33	$123.03	$154.88
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $63.10	Professional	26	$37.15	$46.77	$63.10
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $77.62 / $100.00	Professional	TC	$63.10	$77.62	$100.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $97.72 / $97.72	Facility	26	$47.86	$97.72	$97.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $77.62 / $380.19	Professional		$47.86	$77.62	$380.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $39.81 / $128.82	Professional	26	$22.91	$39.81	$128.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $239.88	Professional	TC	$22.91	$40.74	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $177.83	Professional		$70.79	$128.82	$177.83
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $128.82 / $128.82	Facility	26	$47.86	$128.82	$128.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $239.88 / $380.19	Professional		$66.07	$239.88	$380.19
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $104.71 / $128.82	Professional	26	$30.90	$104.71	$128.82
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $147.91 / $239.88	Professional	TC	$42.66	$147.91	$239.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $194.98 / $380.19	Professional		$69.18	$194.98	$380.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $89.13 / $109.65	Professional	26	$39.81	$89.13	$109.65
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $141.25	Professional	TC	$53.70	$63.10	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $72.44 / $158.49	Professional		$46.77	$72.44	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $72.44	Professional	26	$21.88	$33.88	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $87.10	Professional	TC	$20.89	$38.90	$87.10