Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $89.13 / $457.09	Facility		$42.66	$89.13	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $13.18 / $47.86	Facility	26	$9.12	$13.18	$47.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $154.88 / $575.44	Facility	TC	$19.50	$154.88	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $45.71 / $125.89	Professional		$26.92	$45.71	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $48.98	Professional	26	$8.91	$12.02	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.18 / $67.61	Professional	TC	$18.20	$28.18	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $52.48	Professional		$21.38	$27.54	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $16.98	Professional	26	$7.76	$10.23	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $20.89 / $38.90	Professional	TC	$15.49	$20.89	$38.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $48.98 / $75.86	Facility		$23.99	$48.98	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $60.26	Professional		$28.84	$36.31	$60.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.88 / $20.42	Professional	26	$10.23	$12.88	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $39.81	Professional	TC	$18.20	$23.99	$39.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $31.62 / $50.12	Facility		$14.13	$31.62	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $24.55 / $41.69	Professional		$10.72	$24.55	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $51.29 / $125.89	Facility		$35.48	$51.29	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $79.43	Professional		$26.92	$44.67	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.49 / $28.18	Professional	26	$9.12	$15.49	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $54.95	Professional	TC	$18.20	$28.84	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $87.10	Professional		$33.88	$40.74	$87.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.18 / $26.30	Professional	26	$10.23	$13.18	$26.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $28.84 / $61.66	Professional	TC	$23.44	$28.84	$61.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $25.70 / $54.95	Professional		$10.47	$25.70	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $218.78 / $218.78	Facility		$23.44	$218.78	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $37.15 / $70.79	Professional		$29.51	$37.15	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $23.44	Professional	26	$10.00	$12.88	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.55 / $46.77	Professional	TC	$19.05	$24.55	$46.77