Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.87 / $12.87 / $44.07	Facility	26	$12.87	$12.87	$44.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $46.22 / $80.43	Professional		$40.22	$46.22	$80.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $12.87 / $27.22	Professional	26	$10.93	$12.87	$27.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.08 / $33.28 / $62.60	Professional	TC	$29.08	$33.28	$62.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.96 / $61.95 / $145.97	Professional		$41.96	$61.95	$145.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $17.01 / $39.52	Professional	26	$11.49	$17.01	$39.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.83 / $44.94 / $104.38	Professional	TC	$29.83	$44.94	$104.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $35.61 / $55.48	Professional		$12.62	$35.61	$55.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.64 / $35.79 / $54.92	Facility	26	$30.64	$35.79	$54.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $107.36 / $128.85	Professional		$49.72	$107.36	$128.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.11 / $28.05 / $34.18	Professional	26	$14.11	$28.05	$34.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.06 / $80.31 / $94.68	Professional	TC	$36.06	$80.31	$94.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $80.00 / $80.00	Facility	26	$27.92	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $73.53 / $277.95	Professional		$44.14	$73.53	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $21.42 / $74.58	Professional	26	$12.62	$21.42	$74.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.59 / $51.55 / $203.39	Professional	TC	$31.59	$51.55	$203.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.43 / $71.19	Professional		$19.71	$46.43	$71.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.25 / $104.13 / $148.50	Professional		$74.25	$104.13	$148.50
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $80.00 / $80.00	Facility	26	$13.55	$80.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $210.75 / $277.95	Professional		$57.03	$210.75	$277.95
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $61.20 / $74.58	Professional	26	$17.64	$61.20	$74.58
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $40.77 / $149.55 / $203.39	Professional	TC	$40.77	$149.55	$203.39
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.73 / $19.73 / $19.73	Facility	26	$19.73	$19.73	$19.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.18 / $142.07 / $157.06	Professional		$62.18	$142.07	$157.06
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $19.35 / $28.28	Professional	26	$16.78	$19.35	$28.28
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.99 / $47.97 / $78.33	Professional	TC	$37.99	$47.97	$78.33
United Facility/Professional Professional Modifier Low / Median / High Price $42.27 / $67.97 / $139.85	Professional		$42.27	$67.97	$139.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $19.92 / $40.92	Professional	26	$12.60	$19.92	$40.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $48.77 / $100.07	Professional	TC	$30.76	$48.77	$100.07