Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $3,548.13 / $7,413.10	Facility		$467.74	$3,548.13	$7,413.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $83.18 / $120.23	Facility	26	$38.90	$83.18	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $467.74	Professional		$169.82	$239.88	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $51.29 / $107.15	Professional	26	$37.15	$51.29	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $162.18 / $281.84	Professional	TC	$100.00	$162.18	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $302.00	Professional		$141.25	$169.82	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $53.70 / $77.62	Professional	26	$45.71	$53.70	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $109.65 / $158.49	Professional	TC	$95.50	$109.65	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $416.87	Professional		$147.91	$229.09	$416.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $70.79 / $123.03	Professional	26	$46.77	$70.79	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $158.49 / $309.03	Professional	TC	$74.13	$158.49	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $158.49 / $223.87	Facility		$53.70	$158.49	$223.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $144.54 / $346.74	Professional		$48.98	$144.54	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $269.15 / $436.52	Professional		$147.91	$269.15	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $114.82	Professional	26	$48.98	$70.79	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $199.53 / $354.81	Professional	TC	$91.20	$199.53	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $407.38	Professional		$158.49	$204.17	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.48 / $154.88	Professional	26	$39.81	$52.48	$154.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $151.36 / $407.38	Professional	TC	$117.49	$151.36	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $1,479.11 / $2,511.89	Facility		$213.80	$1,479.11	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $223.87 / $446.68	Professional		$134.90	$223.87	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $120.23	Professional	26	$41.69	$64.57	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $162.18 / $331.13	Professional	TC	$91.20	$162.18	$331.13