Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.48 / $13.60 / $26.11	Facility	26	$7.48	$13.60	$26.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $53.88 / $280.50	Professional		$27.83	$53.88	$280.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.70 / $18.89 / $144.32	Professional	26	$6.70	$18.89	$144.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $28.31 / $82.14	Professional	TC	$18.05	$28.31	$82.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $48.37 / $163.62	Professional		$26.22	$48.37	$163.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $13.60 / $45.84	Professional	26	$7.26	$13.60	$45.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $34.77 / $117.77	Professional	TC	$18.97	$34.77	$117.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.15 / $18.97 / $30.08	Professional		$7.15	$18.97	$30.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.02 / $21.06 / $32.31	Facility	26	$18.02	$21.06	$32.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $72.14 / $81.98	Professional		$37.11	$72.14	$81.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $20.22 / $22.98	Professional	26	$9.71	$20.22	$22.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.58 / $51.91 / $58.99	Professional	TC	$26.58	$51.91	$58.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $103.69 / $103.69 / $103.69	Facility	26	$103.69	$103.69	$103.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $72.38 / $644.00	Professional		$29.86	$72.38	$644.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $15.44 / $228.88	Professional	26	$8.34	$15.44	$228.88
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $53.98 / $542.00	Professional	TC	$21.22	$53.98	$542.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $52.71 / $73.66	Professional		$20.72	$52.71	$73.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $70.45 / $125.61	Professional		$46.18	$70.45	$125.61
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $103.69 / $103.69	Facility	26	$100.00	$103.69	$103.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $159.99 / $644.00	Professional		$38.72	$159.99	$644.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $36.28 / $228.88	Professional	26	$10.85	$36.28	$228.88
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $135.03 / $542.00	Professional	TC	$27.87	$135.03	$542.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $110.23 / $170.91 / $170.91	Professional		$110.23	$170.91	$170.91
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.24 / $36.65 / $39.36	Professional	26	$30.24	$36.65	$39.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.98 / $86.12 / $118.12	Professional	TC	$79.98	$86.12	$118.12
United Facility/Professional Professional Modifier Low / Median / High Price $27.07 / $56.24 / $132.40	Professional		$27.07	$56.24	$132.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $13.98 / $31.73	Professional	26	$7.58	$13.98	$31.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $37.47 / $88.27	Professional	TC	$19.48	$37.47	$88.27