Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.86 / $27.43 / $81.72	Facility	26	$23.86	$27.43	$81.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.99 / $37.10 / $135.19	Professional		$30.99	$37.10	$135.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $24.45 / $114.05	Professional	26	$20.30	$24.45	$114.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.34 / $17.45 / $21.84	Professional	52	$15.34	$17.45	$21.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.18 / $12.38 / $20.14	Professional	TC	$10.18	$12.38	$20.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.89 / $111.44	Professional		$32.36	$47.89	$111.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.10 / $32.08 / $75.29	Professional	26	$22.10	$32.08	$75.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.39 / $16.42 / $39.22	Professional	TC	$10.39	$16.42	$39.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.87 / $25.46 / $43.94	Professional		$12.87	$25.46	$43.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.67 / $67.39 / $103.38	Facility	26	$57.67	$67.39	$103.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $81.12 / $98.39	Professional		$38.61	$81.12	$98.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.50 / $52.46 / $63.40	Professional	26	$25.50	$52.46	$63.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $30.22 / $34.99	Professional	TC	$13.35	$30.22	$34.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $51.77 / $98.42 / $98.42	Facility	26	$51.77	$98.42	$98.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $56.93 / $209.51	Professional		$34.25	$56.93	$209.51
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.33 / $39.21 / $138.46	Professional	26	$23.33	$39.21	$138.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.98 / $17.75 / $71.05	Professional	TC	$10.98	$17.75	$71.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.68 / $46.43 / $70.31	Professional		$20.68	$46.43	$70.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.65 / $79.44 / $111.43	Professional		$56.65	$79.44	$111.43
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $98.42 / $98.42	Facility	26	$25.15	$98.42	$98.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $163.69 / $209.51	Professional		$48.28	$163.69	$209.51
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $113.45 / $138.46	Professional	26	$32.86	$113.45	$138.46
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $14.78 / $52.11 / $71.05	Professional	TC	$14.78	$52.11	$71.05
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $35.42 / $35.42 / $35.42	Facility	26	$35.42	$35.42	$35.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.05 / $99.56 / $119.88	Professional		$47.05	$99.56	$119.88
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.11 / $35.42 / $44.82	Professional	26	$30.11	$35.42	$44.82
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.32 / $16.86 / $21.32	Professional	TC	$14.32	$16.86	$21.32
United Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $53.30 / $111.50	Professional		$33.95	$53.30	$111.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.76 / $36.07 / $75.84	Professional	26	$22.76	$36.07	$75.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.98 / $17.53 / $37.69	Professional	TC	$10.98	$17.53	$37.69