Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $10.02 / $29.91	Facility	26	$8.73	$10.02	$29.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $38.49 / $187.00	Professional		$25.22	$38.49	$187.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.07 / $47.07 / $47.07	Professional	25	$47.07	$47.07	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.57 / $45.00	Professional	26	$7.59	$9.57	$45.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.52 / $21.85 / $71.18	Professional	TC	$17.52	$21.85	$71.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.66 / $39.38 / $98.98	Professional		$27.66	$39.38	$98.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $11.54 / $26.90	Professional	26	$8.11	$11.54	$26.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $28.84 / $71.25	Professional	TC	$19.69	$28.84	$71.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.63 / $21.41 / $33.78	Professional		$8.63	$21.41	$33.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.73 / $24.22 / $37.15	Facility	26	$20.73	$24.22	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $69.00 / $80.27	Professional		$37.21	$69.00	$80.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $18.98 / $23.21	Professional	26	$9.10	$18.98	$23.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.58 / $48.39 / $57.87	Professional	TC	$26.58	$48.39	$57.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.87 / $100.00 / $100.00	Facility	26	$18.87	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $63.94 / $400.00	Professional		$34.79	$63.94	$400.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $16.64 / $132.09	Professional	26	$8.66	$16.64	$132.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.31 / $47.23 / $135.32	Professional	TC	$26.31	$47.23	$135.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.43 / $71.18	Professional		$19.71	$46.43	$71.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.10 / $73.73 / $282.20	Professional		$45.10	$73.73	$282.20
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $10.67 / $100.00 / $100.00	Facility	26	$10.67	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $170.55 / $400.00	Professional		$45.41	$170.55	$400.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $54.42 / $132.09	Professional	26	$12.29	$54.42	$132.09
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $31.97 / $129.00 / $135.32	Professional	TC	$31.97	$129.00	$135.32
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.22 / $59.22 / $59.22	Facility	26	$59.22	$59.22	$59.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $53.93 / $95.58 / $95.58	Professional		$53.93	$95.58	$95.58
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $16.02 / $53.30	Professional	26	$11.64	$16.02	$53.30
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $40.94 / $51.80	Professional	TC	$27.69	$40.94	$51.80
United Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $81.16 / $129.08	Professional		$38.50	$81.16	$129.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $14.50 / $90.00	Professional	26	$8.66	$14.50	$90.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $39.94 / $86.61	Professional	TC	$24.52	$39.94	$86.61