Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.72 / $88.94 / $431.24	Facility		$40.72	$88.94	$431.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.05 / $10.33 / $46.06	Facility	26	$9.05	$10.33	$46.06
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.32 / $182.41 / $513.36	Facility	TC	$20.32	$182.41	$513.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $37.31 / $99.98	Professional		$27.02	$37.31	$99.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $11.27 / $43.78	Professional	26	$8.85	$11.27	$43.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $22.23 / $56.80	Professional	TC	$17.92	$22.23	$56.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $43.27 / $56.99	Professional		$26.14	$43.27	$56.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $14.66 / $19.21	Professional	26	$8.30	$14.66	$19.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $37.26 / $40.04	Professional	TC	$17.57	$37.26	$40.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.40 / $52.82 / $75.91	Facility		$29.40	$52.82	$75.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $37.71 / $78.73	Professional		$28.92	$37.71	$78.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $13.40 / $24.24	Professional	26	$9.67	$13.40	$24.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $26.10 / $54.49	Professional	TC	$18.19	$26.10	$54.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.75 / $28.10 / $45.75	Facility		$12.75	$28.10	$45.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.63 / $24.84 / $45.61	Professional		$10.63	$24.84	$45.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.60 / $51.19 / $127.31	Facility		$36.60	$51.19	$127.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.93 / $46.92 / $83.41	Professional		$29.93	$46.92	$83.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $16.63 / $29.38	Professional	26	$10.70	$16.63	$29.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $31.26 / $58.00	Professional	TC	$18.97	$31.26	$58.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $39.22 / $120.13	Professional		$30.74	$39.22	$120.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $14.49 / $36.99	Professional	26	$11.07	$14.49	$36.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.88 / $32.57 / $83.14	Professional	TC	$24.88	$32.57	$83.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.67 / $32.28 / $55.75	Professional		$11.67	$32.28	$55.75
United Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $39.21 / $72.18	Professional		$29.84	$39.21	$72.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $13.77 / $24.83	Professional	26	$10.28	$13.77	$24.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $26.36 / $47.65	Professional	TC	$19.39	$26.36	$47.65