Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $227.34 / $580.90	Facility		$33.22	$227.34	$580.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.29 / $12.09 / $37.15	Facility	26	$7.29	$12.09	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.35 / $207.79 / $899.46	Facility	TC	$16.35	$207.79	$899.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.97 / $30.73 / $81.75	Professional		$21.97	$30.73	$81.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $9.15 / $24.44	Professional	26	$7.30	$9.15	$24.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.04 / $19.62 / $57.77	Professional	TC	$15.04	$19.62	$57.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.97 / $42.14 / $50.48	Professional		$20.97	$42.14	$50.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $11.79 / $15.51	Professional	26	$6.68	$11.79	$15.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $17.39 / $96.48	Professional	TC	$17.39	$17.39	$96.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.52 / $44.44 / $63.99	Facility		$26.52	$44.44	$63.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.47 / $38.46 / $79.26	Professional		$24.47	$38.46	$79.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.74 / $23.70	Professional	26	$7.76	$11.74	$23.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.54 / $25.36 / $54.45	Professional	TC	$16.54	$25.36	$54.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.27 / $23.70 / $38.07	Facility		$10.27	$23.70	$38.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $20.94 / $38.50	Professional		$8.51	$20.94	$38.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.86 / $43.16 / $171.35	Facility		$30.86	$43.16	$171.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $42.53 / $75.55	Professional		$24.68	$42.53	$75.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $13.78 / $22.69	Professional	26	$8.01	$13.78	$22.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $29.77 / $53.93	Professional	TC	$17.37	$29.77	$53.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.91 / $47.68 / $111.10	Professional		$29.91	$47.68	$111.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $14.24 / $30.73	Professional	26	$8.93	$14.24	$30.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.98 / $33.44 / $80.33	Professional	TC	$20.98	$33.44	$80.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.42 / $28.40 / $50.60	Professional		$11.42	$28.40	$50.60
United Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $36.08 / $63.22	Professional		$25.98	$36.08	$63.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.81 / $19.22	Professional	26	$7.95	$10.81	$19.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $23.82 / $43.43	Professional	TC	$18.19	$23.82	$43.43