Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.39 / $102.75 / $702.46	Facility		$62.39	$102.75	$702.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.10 / $17.10 / $31.14	Facility	26	$17.10	$17.10	$31.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.14 / $74.44 / $146.75	Professional		$60.14	$74.44	$146.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $18.76 / $30.50	Professional	26	$16.57	$18.76	$30.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.33 / $48.99 / $122.47	Professional	TC	$43.33	$48.99	$122.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.16 / $89.95 / $120.23	Professional		$83.16	$89.95	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Professional	26	$32.15	$32.15	$32.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $25.13 / $25.13	Facility		$25.13	$25.13	$25.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.55 / $98.22 / $188.95	Professional		$49.55	$98.22	$188.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $23.08 / $43.68	Professional	26	$13.28	$23.08	$43.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.85 / $72.41 / $143.93	Professional	TC	$33.85	$72.41	$143.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.39 / $91.54 / $112.91	Facility		$21.39	$91.54	$112.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.17 / $121.17 / $121.17	Facility		$121.17	$121.17	$121.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $113.97 / $242.28	Professional		$63.82	$113.97	$242.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $24.85 / $51.15	Professional	26	$18.23	$24.85	$51.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.67 / $88.29 / $204.50	Professional	TC	$45.67	$88.29	$204.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.37 / $83.16 / $263.95	Professional		$70.37	$83.16	$263.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $22.74 / $88.24	Professional	26	$19.23	$22.74	$88.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.13 / $60.42 / $197.52	Professional	TC	$51.13	$60.42	$197.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $64.02 / $107.69	Professional		$18.57	$64.02	$107.69
United Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $120.36 / $209.55	Professional		$63.00	$120.36	$209.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $25.60 / $42.44	Professional	26	$17.68	$25.60	$42.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.77 / $92.20 / $161.18	Professional	TC	$43.77	$92.20	$161.18