Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.23 / $13.23 / $45.31	Facility	26	$13.23	$13.23	$45.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $42.56 / $77.09	Professional		$37.03	$42.56	$77.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $13.11 / $18.44	Professional	26	$11.14	$13.11	$18.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.21 / $29.33 / $59.65	Professional	TC	$25.21	$29.33	$59.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $56.24 / $134.88	Professional		$38.00	$56.24	$134.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $17.48 / $40.50	Professional	26	$11.81	$17.48	$40.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.76 / $38.75 / $93.07	Professional	TC	$26.76	$38.75	$93.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.54 / $36.86 / $56.54	Facility	26	$31.54	$36.86	$56.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $105.77 / $127.88	Professional		$49.72	$105.77	$127.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.11 / $28.88 / $35.14	Professional	26	$14.11	$28.88	$35.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.61 / $77.93 / $92.74	Professional	TC	$35.61	$77.93	$92.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.55 / $80.00 / $80.00	Facility	26	$28.55	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.50 / $69.26 / $251.93	Professional		$41.50	$69.26	$251.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.90 / $21.73 / $76.73	Professional	26	$12.90	$21.73	$76.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $47.38 / $175.19	Professional	TC	$28.51	$47.38	$175.19
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 $73.15 / $102.58 / $146.30	Professional		$73.15	$102.58	$146.30
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $80.00 / $80.00	Facility	26	$13.91	$80.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $197.05 / $251.93	Professional		$54.55	$197.05	$251.93
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $62.90 / $76.73	Professional	26	$18.14	$62.90	$76.73
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $36.68 / $138.11 / $175.19	Professional	TC	$36.68	$138.11	$175.19
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $19.63 / $19.63	Facility	26	$19.63	$19.63	$19.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.04 / $137.01 / $155.86	Professional		$54.04	$137.01	$155.86
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.69 / $19.63 / $29.08	Professional	26	$16.69	$19.63	$29.08
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.35 / $43.62 / $76.73	Professional	TC	$34.35	$43.62	$76.73
United Facility/Professional Professional Modifier Low / Median / High Price $41.13 / $65.03 / $131.76	Professional		$41.13	$65.03	$131.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.83 / $19.97 / $41.35	Professional	26	$12.83	$19.97	$41.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $44.17 / $90.24	Professional	TC	$28.51	$44.17	$90.24