Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $21.88 / $21.88	Facility	26	$15.14	$21.88	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $104.71	Professional		$33.88	$42.66	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $48.98	Professional	26	$12.02	$15.14	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.12 / $46.77	Professional	TC	$19.95	$25.12	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $125.89	Professional		$38.02	$54.95	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $20.42 / $46.77	Professional	26	$14.45	$20.42	$46.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $79.43	Professional	TC	$23.44	$33.88	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $31.62 / $52.48	Professional		$16.98	$31.62	$52.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $41.69 / $69.18	Facility	26	$11.48	$41.69	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $123.03	Professional		$41.69	$87.10	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $31.62 / $44.67	Professional	26	$15.49	$31.62	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $54.95 / $79.43	Professional	TC	$25.12	$54.95	$79.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $117.49	Professional		$67.61	$81.28	$117.49
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $41.69	Professional	26	$24.55	$29.51	$41.69
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $74.13	Professional	TC	$42.66	$52.48	$74.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $100.00 / $100.00	Facility	26	$33.88	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $346.74	Professional		$38.02	$67.61	$346.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $26.30 / $89.13	Professional	26	$14.79	$26.30	$89.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $42.66 / $199.53	Professional	TC	$23.44	$42.66	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $138.04	Professional		$48.98	$100.00	$138.04
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $190.55 / $346.74	Professional		$42.66	$190.55	$346.74
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $74.13 / $89.13	Professional	26	$15.14	$74.13	$89.13
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $114.82 / $199.53	Professional	TC	$26.30	$114.82	$199.53
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $117.49 / $138.04	Professional		$60.26	$117.49	$138.04
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $45.71	Professional	26	$21.88	$28.18	$45.71
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $37.15 / $61.66	Professional	TC	$31.62	$37.15	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $117.49	Professional		$37.15	$52.48	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $20.89 / $44.67	Professional	26	$14.13	$20.89	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $72.44	Professional	TC	$22.91	$33.11	$72.44