Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.99 / $12.63 / $37.65	Facility	26	$10.99	$12.63	$37.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.45 / $65.67 / $301.00	Professional		$36.45	$65.67	$301.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $14.16 / $73.00	Professional	26	$9.49	$14.16	$73.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $33.24 / $74.13	Professional	TC	$26.30	$33.24	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.52 / $63.71 / $152.63	Professional		$40.52	$63.71	$152.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $15.83 / $37.50	Professional	26	$10.34	$15.83	$37.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.21 / $48.04 / $121.49	Professional	TC	$30.21	$48.04	$121.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.81 / $32.10 / $48.07	Professional		$10.81	$32.10	$48.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.13 / $30.54 / $46.85	Facility	26	$26.13	$30.54	$46.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.35 / $98.84 / $125.96	Professional		$57.35	$98.84	$125.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.63 / $24.17 / $29.42	Professional	26	$13.63	$24.17	$29.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.11 / $73.15 / $97.22	Professional	TC	$42.11	$73.15	$97.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.82 / $100.00 / $104.00	Facility	26	$23.82	$100.00	$104.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $106.34 / $632.00	Professional		$59.90	$106.34	$632.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $25.54 / $223.21	Professional	26	$13.35	$25.54	$223.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.95 / $83.05 / $259.02	Professional	TC	$44.95	$83.05	$259.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.76 / $73.66	Professional		$19.71	$46.76	$73.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $105.21 / $235.19	Professional		$64.34	$105.21	$235.19
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $13.43 / $100.00 / $100.00	Facility	26	$13.43	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $285.05 / $632.00	Professional		$65.73	$285.05	$632.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $64.70 / $223.21	Professional	26	$16.91	$64.70	$223.21
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $52.11 / $220.35 / $259.02	Professional	TC	$52.11	$220.35	$259.02
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 $88.74 / $136.88 / $175.59	Professional		$88.74	$136.88	$175.59
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $24.01 / $53.30	Professional	26	$14.65	$24.01	$53.30
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.70 / $72.00 / $91.10	Professional	TC	$41.70	$72.00	$91.10
United Facility/Professional Professional Modifier Low / Median / High Price $54.51 / $90.00 / $187.39	Professional		$54.51	$90.00	$187.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $20.54 / $42.54	Professional	26	$12.60	$20.54	$42.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.27 / $67.87 / $147.33	Professional	TC	$41.27	$67.87	$147.33