Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $19.50 / $48.98	Facility	26	$9.33	$19.50	$48.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $97.72 / $549.54	Facility	TC	$29.51	$97.72	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $54.95 / $181.97	Professional		$23.99	$54.95	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $22.39 / $56.23	Professional	26	$8.91	$22.39	$56.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $107.15 / $269.15	Professional	50	$39.81	$107.15	$269.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $93.33	Professional	TC	$26.92	$43.65	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $39.81 / $77.62	Professional		$31.62	$39.81	$77.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $19.95	Professional	26	$8.32	$11.22	$19.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $72.44 / $123.03	Professional	50	$51.29	$72.44	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $46.77 / $79.43	Professional	TC	$28.84	$46.77	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $87.10	Professional		$36.31	$50.12	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $25.12	Professional	26	$10.72	$14.45	$25.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $75.86 / $131.83	Professional	50	$56.23	$75.86	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $63.10	Professional	TC	$25.70	$36.31	$63.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $38.90 / $57.54	Professional		$11.22	$38.90	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $57.54 / $112.20	Professional		$36.31	$57.54	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.22 / $28.18	Professional	26	$9.77	$16.22	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $85.11	Professional	TC	$25.70	$42.66	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $66.07 / $144.54	Professional		$50.12	$66.07	$144.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.14 / $39.81	Professional	26	$11.22	$15.14	$39.81
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $41.69 / $41.69 / $58.88	Professional	52	$41.69	$41.69	$58.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $51.29 / $102.33	Professional	TC	$38.90	$51.29	$102.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $45.71 / $81.28	Professional		$11.48	$45.71	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $48.98 / $89.13	Professional		$36.31	$48.98	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $23.99	Professional	26	$10.00	$12.88	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $36.31 / $67.61	Professional	TC	$26.30	$36.31	$67.61