Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.34 / $34.34 / $65.84	Facility	26	$34.34	$34.34	$65.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.57 / $97.65 / $314.00	Professional		$56.57	$97.65	$314.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $67.77 / $207.90	Professional	26	$18.72	$67.77	$207.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.10 / $61.34 / $136.00	Professional	TC	$34.10	$61.34	$136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $97.65 / $332.38	Professional		$52.45	$97.65	$332.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.09 / $34.34 / $115.71	Professional	26	$18.09	$34.34	$115.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $63.31 / $216.67	Professional	TC	$34.14	$63.31	$216.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.96 / $36.15 / $61.25	Professional		$17.96	$36.15	$61.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.96 / $53.70 / $82.38	Facility	26	$45.96	$53.70	$82.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $146.53 / $166.51	Professional		$75.42	$146.53	$166.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $51.01 / $57.96	Professional	26	$23.64	$51.01	$57.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.82 / $95.52 / $108.55	Professional	TC	$48.82	$95.52	$108.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.36 / $128.36 / $128.36	Facility	26	$128.36	$128.36	$128.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $132.65 / $604.11	Professional		$60.42	$132.65	$604.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.87 / $38.97 / $456.30	Professional	26	$20.87	$38.97	$456.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $85.98 / $388.70	Professional	TC	$37.54	$85.98	$388.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $55.25 / $77.04	Professional		$21.28	$55.25	$77.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.62 / $142.80 / $308.32	Professional		$93.62	$142.80	$308.32
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $128.36 / $128.36	Facility	26	$100.00	$128.36	$128.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $268.92 / $604.11	Professional		$78.65	$268.92	$604.11
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $27.38 / $95.23 / $456.30	Professional	26	$27.38	$95.23	$456.30
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $51.27 / $207.64 / $388.70	Professional	TC	$51.27	$207.64	$388.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $220.31 / $347.20 / $347.20	Professional		$220.31	$347.20	$347.20
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.03 / $92.61 / $103.35	Professional	26	$76.03	$92.61	$103.35
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $139.30 / $144.27 / $182.39	Professional	TC	$139.30	$144.27	$182.39
United Facility/Professional Professional Modifier Low / Median / High Price $58.52 / $114.18 / $247.91	Professional		$58.52	$114.18	$247.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.71 / $36.63 / $81.54	Professional	26	$19.71	$36.63	$81.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $73.59 / $160.69	Professional	TC	$35.72	$73.59	$160.69