Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.58 / $194.29 / $525.14	Facility		$50.58	$194.29	$525.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.29 / $10.92 / $37.15	Facility	26	$7.29	$10.92	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.57 / $182.92 / $522.26	Facility	TC	$24.57	$182.92	$522.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.73 / $35.40 / $122.11	Professional		$8.73	$35.40	$122.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $14.24 / $40.74	Professional	26	$7.30	$14.24	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.93 / $123.21 / $213.02	Professional	50	$31.93	$123.21	$213.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $28.40 / $110.00	Professional	TC	$21.64	$28.40	$110.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $47.55 / $62.63	Professional		$27.78	$47.55	$62.63
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 50 Low / Median / High Price $50.51 / $71.31 / $92.38	Professional	50	$50.51	$71.31	$92.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.04 / $46.29 / $47.78	Professional	TC	$42.04	$46.29	$47.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.09 / $58.95 / $93.25	Facility		$32.09	$58.95	$93.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.50 / $41.80 / $87.27	Professional		$27.50	$41.80	$87.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $11.39 / $22.33	Professional	26	$7.75	$11.39	$22.33
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.64 / $63.52 / $130.90	Professional	50	$41.64	$63.52	$130.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $32.42 / $65.70	Professional	TC	$21.02	$32.42	$65.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.27 / $34.90 / $50.71	Facility		$10.27	$34.90	$50.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $30.86 / $55.29	Professional		$8.51	$30.86	$55.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.15 / $63.62 / $136.00	Facility		$42.15	$63.62	$136.00
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 $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.75 / $50.30 / $88.74	Professional		$28.75	$50.30	$88.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $13.41 / $22.77	Professional	26	$8.01	$13.41	$22.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $37.08 / $68.92	Professional	TC	$21.01	$37.08	$68.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.84 / $63.52 / $133.18	Professional		$39.84	$63.52	$133.18
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 $30.91 / $49.28 / $103.33	Professional	TC	$30.91	$49.28	$103.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.70 / $39.19 / $64.65	Professional		$11.70	$39.19	$64.65
United Facility/Professional Facility Modifier Low / Median / High Price $21.57 / $185.87 / $216.45	Facility		$21.57	$185.87	$216.45
United Facility/Professional Professional Modifier Low / Median / High Price $30.30 / $42.37 / $76.00	Professional		$30.30	$42.37	$76.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.82 / $19.28	Professional	26	$7.95	$10.82	$19.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.57 / $29.87 / $57.66	Professional	TC	$21.57	$29.87	$57.66