Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.96 / $16.22	Facility	26	$8.91	$10.96	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $223.87	Professional		$51.29	$64.57	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $34.67	Professional	26	$7.94	$9.77	$34.67
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	52	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $51.29 / $95.50	Professional	TC	$41.69	$51.29	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $181.97	Professional		$54.95	$81.28	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.59 / $28.84	Professional	26	$8.71	$12.59	$28.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $67.61 / $154.88	Professional	TC	$45.71	$67.61	$154.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $54.95 / $77.62	Professional		$10.47	$54.95	$77.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $25.70 / $41.69	Facility	26	$7.08	$25.70	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $123.03 / $177.83	Professional		$60.26	$123.03	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $18.62 / $25.70	Professional	26	$9.33	$18.62	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $104.71 / $151.36	Professional	TC	$50.12	$104.71	$151.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $169.82	Professional		$97.72	$117.49	$169.82
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.20 / $26.30	Professional	26	$15.14	$18.20	$26.30
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $97.72 / $141.25	Professional	TC	$81.28	$97.72	$141.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $79.43 / $131.83	Facility	26	$20.42	$79.43	$131.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $371.54	Professional		$54.95	$93.33	$371.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.49 / $54.95	Professional	26	$9.12	$15.49	$54.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $77.62 / $316.23	Professional	TC	$46.77	$77.62	$316.23
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 $74.13 / $141.25 / $208.93	Professional		$74.13	$141.25	$208.93
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $79.43 / $79.43	Facility	26	$20.42	$79.43	$79.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $213.80 / $371.54	Professional		$58.88	$213.80	$371.54
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $44.67 / $54.95	Professional	26	$9.12	$44.67	$54.95
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $229.09 / $316.23	Professional	TC	$48.98	$229.09	$316.23
Security Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Facility	26	$19.95	$19.95	$19.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $199.53	Professional		$74.13	$114.82	$199.53
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $17.38 / $72.44	Professional	26	$14.13	$17.38	$72.44
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $81.28 / $302.00	Professional	TC	$58.88	$81.28	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $77.62 / $169.82	Professional		$54.95	$77.62	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.59 / $27.54	Professional	26	$8.91	$12.59	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $66.07 / $141.25	Professional	TC	$45.71	$66.07	$141.25