Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $229.09 / $501.19	Facility		$32.36	$229.09	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $15.14 / $38.02	Facility	26	$7.24	$15.14	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.98 / $79.43 / $588.84	Facility	TC	$16.98	$79.43	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.02 / $93.33	Professional		$21.88	$38.02	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $33.11	Professional	26	$7.08	$9.33	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $56.23	Professional	TC	$15.14	$21.88	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $46.77	Professional		$18.20	$25.12	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.91 / $15.14	Professional	26	$6.46	$8.91	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.38 / $36.31	Professional	TC	$15.49	$21.38	$36.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $42.66 / $64.57	Facility		$25.70	$42.66	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $81.28	Professional		$25.70	$38.90	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $20.42	Professional	26	$8.51	$11.48	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.12 / $43.65	Professional	TC	$17.38	$25.12	$43.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $26.92 / $42.66	Facility		$11.48	$26.92	$42.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $20.89 / $34.67	Professional		$8.51	$20.89	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $43.65 / $263.03	Facility		$30.90	$43.65	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $39.81 / $70.79	Professional		$22.91	$39.81	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.59 / $21.88	Professional	26	$7.59	$12.59	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $27.54 / $48.98	Professional	TC	$16.98	$27.54	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $100.00	Professional		$28.84	$37.15	$100.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $30.20	Professional	26	$8.51	$11.48	$30.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $77.62	Professional	TC	$19.95	$26.30	$77.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $22.39 / $46.77	Professional		$8.71	$22.39	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $263.03 / $263.03	Facility		$23.44	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $61.66	Professional		$25.70	$32.36	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $18.20	Professional	26	$7.94	$10.00	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.39 / $42.66	Professional	TC	$17.78	$22.39	$42.66