Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.68 / $36.68 / $126.56	Facility	26	$36.68	$36.68	$126.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $113.60 / $235.71	Professional		$64.31	$113.60	$235.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.26 / $36.68 / $100.92	Professional	26	$31.26	$36.68	$100.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $73.72 / $127.53	Professional	TC	$33.03	$73.72	$127.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $150.12 / $436.45	Professional		$59.96	$150.12	$436.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $48.48 / $146.63	Professional	26	$33.34	$48.48	$146.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.95 / $101.64 / $290.58	Professional	TC	$26.95	$101.64	$290.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $72.48 / $124.42	Professional		$37.61	$72.48	$124.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.11 / $105.30 / $161.54	Facility	26	$90.11	$105.30	$161.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $264.56 / $335.69	Professional		$89.33	$264.56	$335.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $86.37 / $123.88	Professional	26	$40.82	$86.37	$123.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.66 / $178.19 / $228.69	Professional	TC	$72.66	$178.19	$228.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $212.86 / $687.40	Professional		$74.00	$212.86	$687.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $87.87 / $224.56	Professional	26	$40.03	$87.87	$224.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.91 / $132.69 / $472.45	Professional	TC	$24.91	$132.69	$472.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $80.11 / $191.69	Professional		$38.20	$80.11	$191.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $164.16 / $232.04 / $334.40	Professional		$164.16	$232.04	$334.40
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $152.90 / $152.90 / $152.90	Facility	26	$152.90	$152.90	$152.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $150.03 / $456.95 / $687.40	Professional		$150.03	$456.95	$687.40
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $172.10 / $224.56	Professional	26	$56.84	$172.10	$224.56
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $93.28 / $301.55 / $472.45	Professional	TC	$93.28	$301.55	$472.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $119.16 / $404.40 / $534.32	Professional		$119.16	$404.40	$534.32
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.51 / $86.32 / $109.22	Professional	26	$42.51	$86.32	$109.22
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $90.32 / $115.88 / $169.54	Professional	TC	$90.32	$115.88	$169.54
United Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $186.91 / $342.71	Professional		$78.23	$186.91	$342.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.20 / $74.18 / $129.08	Professional	26	$39.20	$74.18	$129.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.31 / $114.26 / $213.63	Professional	TC	$27.31	$114.26	$213.63