Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.38 / $113.46 / $414.16	Facility		$30.38	$113.46	$414.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $18.16 / $43.10	Facility	26	$7.59	$18.16	$43.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.79 / $94.02 / $1,046.18	Facility	TC	$22.79	$94.02	$1,046.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $39.88 / $103.44	Professional		$29.08	$39.88	$103.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $11.85 / $32.83	Professional	26	$7.51	$11.85	$32.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $25.92 / $60.92	Professional	TC	$19.36	$25.92	$60.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.82 / $41.18 / $59.40	Professional		$26.82	$41.18	$59.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.10 / $12.29 / $17.22	Professional	26	$7.10	$12.29	$17.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.96 / $97.96 / $97.96	Professional	TC	$97.96	$97.96	$97.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.20 / $61.55 / $88.93	Facility		$33.20	$61.55	$88.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $46.60 / $89.15	Professional		$32.26	$46.60	$89.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $14.95 / $25.98	Professional	26	$8.44	$14.95	$25.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $31.56 / $63.81	Professional	TC	$21.49	$31.56	$63.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.69 / $32.90 / $48.90	Facility		$10.69	$32.90	$48.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.88 / $29.09 / $53.37	Professional		$8.88	$29.09	$53.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.26 / $59.97 / $171.35	Facility		$40.26	$59.97	$171.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.42 / $55.62 / $94.96	Professional		$32.42	$55.62	$94.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $17.16 / $27.62	Professional	26	$10.55	$17.16	$27.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $38.59 / $67.93	Professional	TC	$22.86	$38.59	$67.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.42 / $61.25 / $128.46	Professional		$38.42	$61.25	$128.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $16.88 / $44.32	Professional	26	$9.27	$16.88	$44.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.14 / $46.45 / $98.29	Professional	TC	$29.14	$46.45	$98.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.05 / $33.59 / $60.85	Professional		$9.05	$33.59	$60.85
United Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $45.00 / $79.03	Professional		$33.92	$45.00	$79.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $14.17 / $23.27	Professional	26	$9.94	$14.17	$23.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $30.86 / $56.09	Professional	TC	$22.99	$30.86	$56.09