Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.71 / $14.76 / $34.15	Facility	26	$6.71	$14.76	$34.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.42 / $32.00 / $79.15	Professional		$18.42	$32.00	$79.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.70 / $10.47 / $26.74	Professional	26	$6.70	$10.47	$26.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $97.50 / $141.94 / $283.11	Professional	50	$97.50	$141.94	$283.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.58 / $12.27 / $29.50	Professional	52	$10.58	$12.27	$29.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $21.27 / $49.10	Professional	TC	$16.39	$21.27	$49.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $44.66 / $51.08	Professional		$18.55	$44.66	$51.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $10.88 / $14.29	Professional	26	$6.47	$10.88	$14.29
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $65.12 / $65.12 / $70.98	Professional	50	$65.12	$65.12	$70.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $33.03 / $78.68	Professional	TC	$18.28	$33.03	$78.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.43 / $35.15 / $69.53	Professional		$24.43	$35.15	$69.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $10.48 / $20.59	Professional	26	$7.16	$10.48	$20.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.64 / $53.41 / $105.66	Professional	50	$36.64	$53.41	$105.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $24.25 / $49.90	Professional	TC	$16.80	$24.25	$49.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $22.00 / $40.44	Professional		$7.83	$22.00	$40.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $41.21 / $70.77	Professional		$24.32	$41.21	$70.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $12.33 / $20.79	Professional	26	$7.38	$12.33	$20.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $30.11 / $52.22	Professional	TC	$17.91	$30.11	$52.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.26 / $48.24 / $101.17	Professional		$30.26	$48.24	$101.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $13.12 / $28.26	Professional	26	$8.23	$13.12	$28.26
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $25.20 / $25.20 / $35.40	Professional	52	$25.20	$25.20	$35.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.04 / $35.14 / $73.69	Professional	TC	$22.04	$35.14	$73.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $29.06 / $54.80	Professional		$10.80	$29.06	$54.80
United Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $35.79 / $62.43	Professional		$25.65	$35.79	$62.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $9.94 / $17.67	Professional	26	$7.27	$9.94	$17.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.77 / $24.20 / $43.65	Professional	TC	$17.77	$24.20	$43.65