Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $131.83	Facility	26	$70.79	$70.79	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $194.98	Professional		$64.57	$89.13	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $141.25	Professional	26	$33.88	$48.98	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $70.79	Professional	TC	$23.99	$38.02	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $114.82 / $338.84	Professional		$61.66	$114.82	$338.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $60.26 / $181.97	Professional	26	$37.15	$60.26	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $52.48 / $154.88	Professional	TC	$22.39	$52.48	$154.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $109.65 / $177.83	Facility	26	$95.50	$109.65	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $208.93 / $239.88	Professional		$107.15	$208.93	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $104.71 / $128.82	Professional	26	$54.95	$104.71	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $97.72 / $123.03	Professional	TC	$52.48	$97.72	$123.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $204.17	Professional		$128.82	$165.96	$204.17
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $85.11 / $107.15	Professional	26	$64.57	$85.11	$107.15
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $81.28 / $102.33	Professional	TC	$63.10	$81.28	$102.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $177.83 / $177.83	Facility	26	$83.18	$177.83	$177.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $120.23 / $562.34	Professional		$69.18	$120.23	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $77.62 / $234.42	Professional	26	$40.74	$77.62	$234.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $41.69 / $245.47	Professional	TC	$25.70	$41.69	$245.47
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 $91.20 / $162.18 / $234.42	Professional		$91.20	$162.18	$234.42
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $229.09 / $229.09	Facility	26	$83.18	$229.09	$229.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $323.59 / $562.34	Professional		$89.13	$323.59	$562.34
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $190.55 / $234.42	Professional	26	$53.70	$190.55	$234.42
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $147.91 / $245.47	Professional	TC	$43.65	$147.91	$245.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $489.78	Professional		$229.09	$338.84	$489.78
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $190.55 / $234.42	Professional	26	$69.18	$190.55	$234.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $141.25	Professional	TC	$67.61	$79.43	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $102.33 / $223.87	Professional		$67.61	$102.33	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $63.10 / $131.83	Professional	26	$38.90	$63.10	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $89.13	Professional	TC	$25.12	$40.74	$89.13