Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $21.68 / $53.05	Facility	26	$15.49	$21.68	$53.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $41.57 / $115.76	Professional		$35.59	$41.57	$115.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.12 / $15.48 / $53.47	Professional	26	$13.12	$15.48	$53.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.15 / $25.83 / $46.85	Professional	TC	$22.15	$25.83	$46.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.82 / $54.46 / $127.68	Professional		$36.82	$54.46	$127.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $20.47 / $47.49	Professional	26	$14.20	$20.47	$47.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.96 / $33.99 / $81.06	Professional	TC	$22.96	$33.99	$81.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $27.79 / $48.57	Professional		$15.15	$27.79	$48.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.95 / $43.17 / $66.23	Facility	26	$36.95	$43.17	$66.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $93.04 / $112.71	Professional		$42.25	$93.04	$112.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $33.83 / $41.13	Professional	26	$16.39	$33.83	$41.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.41 / $60.44 / $71.55	Professional	TC	$26.41	$60.44	$71.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $100.00 / $100.00	Facility	26	$33.53	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $67.55 / $348.00	Professional		$38.54	$67.55	$348.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.05 / $26.53 / $89.60	Professional	26	$15.05	$26.53	$89.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.80 / $42.91 / $198.00	Professional	TC	$23.80	$42.91	$198.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.83 / $46.43 / $71.19	Professional		$19.83	$46.43	$71.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $98.76 / $128.69	Professional		$64.34	$98.76	$128.69
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $18.92 / $100.00 / $100.00	Facility	26	$18.92	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $188.95 / $348.00	Professional		$58.80	$188.95	$348.00
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $73.65 / $89.60	Professional	26	$21.67	$73.65	$89.60
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $37.71 / $115.30 / $198.00	Professional	TC	$37.71	$115.30	$198.00
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.35 / $49.35 / $49.35	Facility	26	$49.35	$49.35	$49.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.17 / $137.37 / $137.37	Professional		$60.17	$137.37	$137.37
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.64 / $28.42 / $44.43	Professional	26	$20.64	$28.42	$44.43
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $37.20 / $59.20	Professional	TC	$31.62	$37.20	$59.20
United Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $58.72 / $132.27	Professional		$37.27	$58.72	$132.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.51 / $28.53 / $69.70	Professional	26	$15.51	$28.53	$69.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.25 / $36.81 / $77.14	Professional	TC	$23.25	$36.81	$77.14