Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $162.18	Facility	26	$83.18	$83.18	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $338.84	Professional		$114.82	$162.18	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $162.18	Professional	26	$38.90	$57.54	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $208.93	Professional	TC	$77.62	$112.20	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $616.60	Professional		$138.04	$208.93	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $199.53	Professional	26	$44.67	$67.61	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $144.54 / $426.58	Professional	TC	$93.33	$144.54	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $131.83 / $213.80	Facility	26	$114.82	$131.83	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $371.54 / $457.09	Professional		$154.88	$371.54	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $120.23 / $144.54	Professional	26	$48.98	$120.23	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $257.04 / $316.23	Professional	TC	$107.15	$257.04	$316.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $281.84 / $380.19	Professional		$245.47	$281.84	$380.19
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $89.13 / $120.23	Professional	26	$77.62	$89.13	$120.23
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $190.55 / $257.04	Professional	TC	$169.82	$190.55	$257.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $1,096.48	Professional		$144.54	$275.42	$1,096.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $87.10 / $446.68	Professional	26	$46.77	$87.10	$446.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $186.21 / $870.96	Professional	TC	$97.72	$186.21	$870.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $138.04	Professional		$32.36	$33.11	$138.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $338.84 / $660.69	Professional		$177.83	$338.84	$660.69
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $275.42 / $275.42	Facility	26	$100.00	$275.42	$275.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $691.83 / $1,096.48	Professional		$177.83	$691.83	$1,096.48
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $223.87 / $446.68	Professional	26	$53.70	$223.87	$446.68
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $489.78 / $891.25	Professional	TC	$120.23	$489.78	$891.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $616.60 / $1,023.29	Professional		$524.81	$616.60	$1,023.29
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $194.98 / $234.42	Professional	26	$186.21	$194.98	$234.42
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $371.54 / $426.58	Professional	TC	$338.84	$371.54	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $537.03	Professional		$144.54	$213.80	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $66.07 / $177.83	Professional	26	$45.71	$66.07	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $144.54 / $371.54	Professional	TC	$97.72	$144.54	$371.54