Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $27.54 / $114.82	Facility		$8.91	$27.54	$114.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $19.05 / $36.31	Facility	26	$10.96	$19.05	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $15.14 / $36.31	Professional		$9.33	$15.14	$36.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $27.54	Professional	26	$6.03	$8.91	$27.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $11.48 / $29.51	Professional	50	$11.48	$11.48	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.89 / $9.55	Professional	TC	$2.00	$3.89	$9.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $13.49 / $22.91	Professional		$8.91	$13.49	$22.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Professional	26	$14.13	$14.13	$14.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $5.62 / $5.62 / $5.62	Professional	TC	$5.62	$5.62	$5.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5.37 / $10.00 / $15.85	Facility		$5.37	$10.00	$15.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $17.38 / $25.12	Professional		$12.02	$17.38	$25.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.75 / $18.20	Professional	26	$8.32	$11.75	$18.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $18.20 / $26.30 / $38.02	Professional	50	$18.20	$26.30	$38.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.95 / $5.13 / $7.94	Professional	TC	$2.95	$5.13	$7.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.68 / $10.72 / $16.98	Facility		$4.68	$10.72	$16.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $8.51 / $14.45	Professional		$3.47	$8.51	$14.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5.75 / $8.51 / $64.57	Facility		$5.75	$8.51	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $17.78 / $29.51	Professional		$11.48	$17.78	$29.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $20.89	Professional	26	$7.59	$12.30	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $5.75 / $9.77	Professional	TC	$2.88	$5.75	$9.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $14.45 / $40.74	Professional		$12.02	$14.45	$40.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $27.54	Professional	26	$7.76	$9.33	$27.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $4.17 / $4.79 / $29.51	Professional	TC	$4.17	$4.79	$29.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $29.51 / $36.31	Professional		$15.14	$29.51	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $70.79 / $70.79	Facility		$11.22	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $15.49 / $26.30	Professional		$11.22	$15.49	$26.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $17.78	Professional	26	$7.76	$10.96	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.24 / $4.68 / $8.51	Professional	TC	$3.24	$4.68	$8.51