Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.80 / $185.04 / $511.50	Facility		$44.80	$185.04	$511.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.00 / $10.47 / $35.68	Facility	26	$7.00	$10.47	$35.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.20 / $244.58 / $522.26	Facility	TC	$22.20	$244.58	$522.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.47 / $31.82 / $98.84	Professional		$8.47	$31.82	$98.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $10.81 / $38.82	Professional	26	$6.90	$10.81	$38.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.44 / $122.20 / $208.50	Professional	50	$38.44	$122.20	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.54 / $14.61 / $36.52	Professional	52	$12.54	$14.61	$36.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $26.40 / $84.95	Professional	TC	$19.46	$26.40	$84.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $42.89 / $58.39	Professional		$25.92	$42.89	$58.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.54 / $11.65 / $14.48	Professional	26	$6.54	$11.65	$14.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $60.55 / $84.97 / $91.87	Professional	50	$60.55	$84.97	$91.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.51 / $43.39 / $44.35	Professional	TC	$41.51	$43.39	$44.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.24 / $54.23 / $85.66	Facility		$29.24	$54.23	$85.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $40.19 / $80.89	Professional		$26.65	$40.19	$80.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $11.28 / $21.77	Professional	26	$7.73	$11.28	$21.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $60.94 / $123.67	Professional	50	$39.81	$60.94	$123.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $29.44 / $61.48	Professional	TC	$19.12	$29.44	$61.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.84 / $31.30 / $46.19	Facility		$9.84	$31.30	$46.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.16 / $27.68 / $50.40	Professional		$8.16	$27.68	$50.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $57.77 / $136.00	Facility		$38.40	$57.77	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $46.66 / $84.43	Professional		$27.35	$46.66	$84.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.60 / $21.76	Professional	26	$7.94	$13.60	$21.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $33.63 / $65.44	Professional	TC	$19.82	$33.63	$65.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $57.85 / $121.32	Professional		$36.29	$57.85	$121.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $13.68 / $29.53	Professional	26	$8.58	$13.68	$29.53
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $30.22 / $30.22 / $42.46	Professional	52	$30.22	$30.22	$42.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.72 / $44.19 / $92.66	Professional	TC	$27.72	$44.19	$92.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $33.54 / $57.67	Professional		$9.36	$33.54	$57.67
United Facility/Professional Facility Modifier Low / Median / High Price $70.86 / $179.57 / $185.87	Facility		$70.86	$179.57	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $40.47 / $72.39	Professional		$28.79	$40.47	$72.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.88 / $19.00	Professional	26	$7.95	$10.88	$19.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $28.87 / $53.88	Professional	TC	$20.83	$28.87	$53.88