Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $194.98 / $537.03	Facility		$52.48	$194.98	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $12.30 / $38.02	Facility	26	$7.24	$12.30	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $114.82 / $537.03	Facility	TC	$23.44	$114.82	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $40.74 / $134.90	Professional		$8.71	$40.74	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $15.85 / $43.65	Professional	26	$7.41	$15.85	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $97.72 / $213.80	Professional	50	$25.70	$97.72	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $83.18	Professional	TC	$21.88	$38.90	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $61.66	Professional		$23.99	$33.11	$61.66
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 50 Low / Median / High Price $40.74 / $64.57 / $95.50	Professional	50	$40.74	$64.57	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $48.98	Professional	TC	$19.95	$30.20	$48.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $53.70 / $93.33	Facility		$30.20	$53.70	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $39.81 / $69.18	Professional		$29.51	$39.81	$69.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $18.62	Professional	26	$8.32	$11.48	$18.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $58.88 / $104.71	Professional	50	$44.67	$58.88	$104.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $51.29	Professional	TC	$20.89	$28.18	$51.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $38.90 / $58.88	Facility		$11.48	$38.90	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $30.90 / $45.71	Professional		$8.51	$30.90	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $63.10 / $158.49	Facility		$42.66	$63.10	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $85.11	Professional		$28.18	$45.71	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $21.88	Professional	26	$7.59	$12.30	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $69.18	Professional	TC	$20.89	$33.88	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $50.12 / $112.20	Professional		$38.90	$50.12	$112.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.75 / $30.20	Professional	26	$8.71	$11.75	$30.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $38.90 / $79.43	Professional	TC	$30.20	$38.90	$79.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $34.67 / $64.57	Professional		$9.12	$34.67	$64.57
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 $28.84 / $38.90 / $70.79	Professional		$28.84	$38.90	$70.79
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 $20.89 / $28.18 / $53.70	Professional	TC	$20.89	$28.18	$53.70