Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.93 / $26.42 / $117.11	Facility		$8.93	$26.42	$117.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.71 / $18.48 / $34.15	Facility	26	$6.71	$18.48	$34.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.39 / $15.08 / $35.88	Professional		$9.39	$15.08	$35.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $8.83 / $22.06	Professional	26	$6.49	$8.83	$22.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $29.65 / $29.65	Professional	50	$11.36	$29.65	$29.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.74 / $4.09 / $11.50	Professional	TC	$2.74	$4.09	$11.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.86 / $19.30 / $20.53	Professional		$18.86	$19.30	$20.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $13.71 / $13.71	Professional	26	$13.71	$13.71	$13.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5.68 / $11.92 / $216.34	Facility		$5.68	$11.92	$216.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.01 / $16.35 / $28.33	Professional		$10.01	$16.35	$28.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.79 / $11.26 / $20.25	Professional	26	$6.79	$11.26	$20.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $15.01 / $24.88 / $43.95	Professional	50	$15.01	$24.88	$43.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.73 / $4.78 / $9.35	Professional	TC	$2.73	$4.78	$9.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.30 / $10.05 / $15.75	Facility		$4.30	$10.05	$15.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.44 / $8.15 / $15.32	Professional		$3.44	$8.15	$15.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5.80 / $8.32 / $79.56	Facility		$5.80	$8.32	$79.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.76 / $8.76 / $8.76	Facility	26	$8.76	$8.76	$8.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.70 / $19.19 / $30.74	Professional		$11.70	$19.19	$30.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $13.14 / $20.77	Professional	26	$8.23	$13.14	$20.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.03 / $6.03 / $9.97	Professional	TC	$3.03	$6.03	$9.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $11.06 / $14.38 / $40.67	Professional		$11.06	$14.38	$40.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $9.71 / $27.48	Professional	26	$7.47	$9.71	$27.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.59 / $4.50 / $31.31	Professional	TC	$3.59	$4.50	$31.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $27.80 / $33.40	Professional		$15.00	$27.80	$33.40
United Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $15.94 / $26.29	Professional		$11.54	$15.94	$26.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $11.31 / $18.11	Professional	26	$7.98	$11.31	$18.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.34 / $5.08 / $8.61	Professional	TC	$3.34	$5.08	$8.61