Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.49 / $10.91 / $32.52	Facility	26	$9.49	$10.91	$32.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.54 / $61.21 / $284.00	Professional		$52.54	$61.21	$284.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $9.49 / $45.60	Professional	26	$8.14	$9.49	$45.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.97 / $29.24 / $39.07	Professional	52	$25.97	$29.24	$39.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $50.40 / $89.08	Professional	TC	$43.71	$50.40	$89.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $80.36 / $185.49	Professional		$53.12	$80.36	$185.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $12.55 / $29.22	Professional	26	$8.28	$12.55	$29.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $67.81 / $156.32	Professional	TC	$44.17	$67.81	$156.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $50.36 / $68.30	Professional		$9.36	$50.36	$68.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.53 / $26.33 / $40.38	Facility	26	$22.53	$26.33	$40.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.19 / $135.19 / $163.19	Professional		$63.19	$135.19	$163.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $20.63 / $25.24	Professional	26	$9.76	$20.63	$25.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.69 / $115.31 / $137.97	Professional	TC	$53.69	$115.31	$137.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $80.00 / $130.33	Facility	26	$20.60	$80.00	$130.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $95.00 / $373.69	Professional		$57.03	$95.00	$373.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.21 / $15.70 / $55.28	Professional	26	$9.21	$15.70	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $47.67 / $78.73 / $318.41	Professional	TC	$47.67	$78.73	$318.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $46.76 / $71.19	Professional		$19.71	$46.76	$71.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $130.49 / $184.80	Professional		$92.40	$130.49	$184.80
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $80.00 / $80.00	Facility	26	$10.06	$80.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $271.75 / $373.69	Professional		$73.70	$271.75	$373.69
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $13.24 / $45.15 / $55.28	Professional	26	$13.24	$45.15	$55.28
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $62.01 / $226.60 / $318.41	Professional	TC	$62.01	$226.60	$318.41
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 $75.51 / $186.36 / $198.92	Professional		$75.51	$186.36	$198.92
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $16.93 / $20.88	Professional	26	$12.65	$16.93	$20.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.54 / $68.25 / $114.15	Professional	TC	$59.54	$68.25	$114.15
United Facility/Professional Professional Modifier Low / Median / High Price $56.74 / $90.00 / $178.64	Professional		$56.74	$90.00	$178.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $14.35 / $30.19	Professional	26	$8.81	$14.35	$30.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.90 / $69.79 / $151.51	Professional	TC	$46.90	$69.79	$151.51