Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $54.95 / $91.20	Facility	26	$46.77	$54.95	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $190.55 / $660.69	Professional		$93.33	$190.55	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $43.65 / $223.87	Professional	26	$22.91	$43.65	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $169.82	Professional	TC	$66.07	$91.20	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $467.74	Professional		$95.50	$147.91	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.02 / $112.20	Professional	26	$25.12	$38.02	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $109.65 / $354.81	Professional	TC	$70.79	$109.65	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $81.28 / $141.25	Professional		$25.70	$81.28	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $75.86 / $120.23	Facility	26	$64.57	$75.86	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $263.03 / $331.13	Professional		$123.03	$263.03	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $67.61 / $83.18	Professional	26	$28.18	$67.61	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $204.17 / $245.47	Professional	TC	$91.20	$204.17	$245.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $204.17 / $295.12	Professional		$177.83	$204.17	$295.12
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $51.29 / $74.13	Professional	26	$44.67	$51.29	$74.13
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $151.36 / $234.42	Professional	TC	$131.83	$151.36	$234.42
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $190.55 / $691.83	Professional		$104.71	$190.55	$691.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $48.98 / $281.84	Professional	26	$26.92	$48.98	$281.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $144.54 / $478.63	Professional	TC	$77.62	$144.54	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $245.47 / $380.19	Professional		$128.82	$245.47	$380.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $154.88 / $154.88	Facility	26	$100.00	$154.88	$154.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $478.63 / $691.83	Professional		$128.82	$478.63	$691.83
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $128.82 / $281.84	Professional	26	$30.90	$128.82	$281.84
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $354.81 / $478.63	Professional	TC	$95.50	$354.81	$478.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $707.95	Professional		$323.59	$524.81	$707.95
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $117.49 / $134.90	Professional	26	$104.71	$117.49	$134.90
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $389.05 / $436.52	Professional	TC	$194.98	$389.05	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $363.08	Professional		$100.00	$151.36	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.02 / $95.50	Professional	26	$26.30	$38.02	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $112.20 / $275.42	Professional	TC	$74.13	$112.20	$275.42