Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.31 / $6.03 / $11.55	Facility	26	$3.31	$6.03	$11.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $62.72 / $263.50	Professional		$23.86	$62.72	$263.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.94 / $8.96 / $84.55	Professional	26	$2.94	$8.96	$84.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.92 / $15.81 / $42.41	Professional	52	$10.92	$15.81	$42.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $39.28 / $118.18	Professional	TC	$20.35	$39.28	$118.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $45.31 / $153.36	Professional		$23.87	$45.31	$153.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.17 / $6.03 / $20.51	Professional	26	$3.17	$6.03	$20.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $39.28 / $133.04	Professional	TC	$21.38	$39.28	$133.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.15 / $20.46 / $27.32	Professional		$3.15	$20.46	$27.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $9.48 / $14.54	Facility	26	$8.11	$9.48	$14.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $67.61 / $118.61	Professional		$34.79	$67.61	$118.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.54 / $8.97 / $10.19	Professional	26	$4.54	$8.97	$10.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.59 / $58.64 / $85.90	Professional	TC	$29.59	$58.64	$85.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.15 / $101.15 / $101.15	Facility	26	$101.15	$101.15	$101.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $78.13 / $724.06	Professional		$27.78	$78.13	$724.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $3.82 / $7.37 / $289.41	Professional	26	$3.82	$7.37	$289.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $67.31 / $660.75	Professional	TC	$23.29	$67.31	$660.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $52.71 / $73.66	Professional		$19.34	$52.71	$73.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $64.73 / $161.19	Professional		$42.44	$64.73	$161.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $101.15 / $101.15	Facility	26	$100.00	$101.15	$101.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $366.49 / $724.06	Professional		$36.29	$366.49	$724.06
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $4.80 / $146.93 / $289.41	Professional	26	$4.80	$146.93	$289.41
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.48 / $354.01 / $660.75	Professional	TC	$31.48	$354.01	$660.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.31 / $160.15 / $310.05	Professional		$103.31	$160.15	$310.05
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $16.28 / $159.46	Professional	26	$13.32	$16.28	$159.46
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.35 / $89.99 / $150.59	Professional	TC	$84.35	$89.99	$150.59
United Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $53.34 / $167.55	Professional		$26.51	$53.34	$167.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.60 / $6.68 / $15.32	Professional	26	$3.60	$6.68	$15.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $53.33 / $147.51	Professional	TC	$22.05	$53.33	$147.51