Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.45 / $26.45 / $30.52	Facility	26	$26.45	$26.45	$30.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.31 / $55.91 / $229.00	Professional		$46.31	$55.91	$229.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $29.31 / $107.23	Professional	26	$26.45	$29.31	$107.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.92 / $25.11 / $87.01	Professional	TC	$19.92	$25.11	$87.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.36 / $92.01 / $255.75	Professional		$48.36	$92.01	$255.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $50.02 / $140.44	Professional	26	$27.60	$50.02	$140.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.73 / $43.22 / $114.10	Professional	TC	$21.73	$43.22	$114.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $33.04 / $55.00	Professional		$16.12	$33.04	$55.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.79 / $87.40 / $116.16	Facility	26	$74.79	$87.40	$116.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $167.33 / $190.15	Professional		$39.28	$167.33	$190.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $99.33 / $112.88	Professional	26	$25.29	$99.33	$112.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $68.01 / $77.29	Professional	TC	$13.99	$68.01	$77.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $141.63 / $141.63 / $141.63	Facility	26	$141.63	$141.63	$141.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.06 / $133.78 / $334.42	Professional		$60.06	$133.78	$334.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.71 / $73.76 / $182.49	Professional	26	$33.71	$73.76	$182.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $60.94 / $151.88	Professional	TC	$26.35	$60.94	$151.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $63.30 / $129.94	Professional		$32.34	$63.30	$129.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.38 / $111.42 / $202.34	Professional		$82.38	$111.42	$202.34
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $141.63 / $141.63	Facility	26	$100.00	$141.63	$141.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $267.55 / $334.42	Professional		$39.28	$267.55	$334.42
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $147.69 / $182.49	Professional	26	$25.29	$147.69	$182.49
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $119.85 / $151.88	Professional	TC	$13.99	$119.85	$151.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.64 / $298.19 / $298.19	Professional		$112.64	$298.19	$298.19
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.08 / $73.04 / $135.76	Professional	26	$62.08	$73.04	$135.76
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $59.47 / $113.95	Professional	TC	$43.65	$59.47	$113.95
United Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $122.18 / $234.51	Professional		$56.72	$122.18	$234.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $69.03 / $129.46	Professional	26	$33.54	$69.03	$129.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.21 / $52.40 / $105.05	Professional	TC	$25.21	$52.40	$105.05