Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $165.96	Facility	26	$46.77	$46.77	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $281.84	Professional		$112.20	$131.83	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $46.77 / $151.36	Professional	26	$39.81	$46.77	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $83.18 / $151.36	Professional	TC	$69.18	$83.18	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $446.68	Professional		$120.23	$169.82	$446.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $138.04	Professional	26	$42.66	$60.26	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $107.15 / $309.03	Professional	TC	$77.62	$107.15	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $134.90 / $218.78	Facility	26	$117.49	$134.90	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $316.23 / $467.74	Professional		$144.54	$316.23	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $114.82 / $165.96	Professional	26	$51.29	$114.82	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $204.17 / $295.12	Professional	TC	$91.20	$204.17	$295.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $331.13	Professional		$208.93	$245.47	$331.13
DeanCare Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $123.03	Professional	26	$77.62	$91.20	$123.03
DeanCare Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $162.18 / $208.93	Professional	TC	$131.83	$162.18	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $281.84 / $954.99	Professional		$131.83	$281.84	$954.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $91.20 / $389.05	Professional	26	$48.98	$91.20	$389.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $186.21 / $776.25	Professional	TC	$83.18	$186.21	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $269.15 / $398.11	Professional		$134.90	$269.15	$398.11
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $281.84 / $281.84	Facility	26	$102.33	$281.84	$281.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $630.96 / $954.99	Professional		$151.36	$630.96	$954.99
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $229.09 / $389.05	Professional	26	$53.70	$229.09	$389.05
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $398.11 / $776.25	Professional	TC	$102.33	$398.11	$776.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $724.44	Professional		$288.40	$436.52	$724.44
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $114.82 / $144.54	Professional	26	$56.23	$114.82	$144.54
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $234.42 / $331.13	Professional	TC	$100.00	$234.42	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $213.80 / $446.68	Professional		$128.82	$213.80	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $75.86 / $158.49	Professional	26	$46.77	$75.86	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $138.04 / $295.12	Professional	TC	$81.28	$138.04	$295.12