Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $199.53 / $831.76	Facility		$41.69	$199.53	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $10.96 / $39.81	Facility	26	$7.59	$10.96	$39.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.45 / $151.36 / $302.00	Facility	TC	$14.45	$151.36	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $29.51 / $95.50	Professional		$18.20	$29.51	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.91 / $39.81	Professional	26	$7.41	$8.91	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $15.85 / $40.74	Professional	TC	$10.47	$15.85	$40.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $20.89 / $43.65	Professional		$16.98	$20.89	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.32 / $14.45	Professional	26	$6.61	$8.32	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $16.22 / $27.54	Professional	TC	$11.75	$16.22	$27.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $28.84 / $56.23	Facility		$13.18	$28.84	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $23.99 / $43.65	Professional		$18.62	$23.99	$43.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.96 / $16.98	Professional	26	$8.51	$10.96	$16.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.88 / $28.18	Professional	TC	$10.00	$12.88	$28.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $23.99 / $38.90	Facility		$11.75	$23.99	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $18.62 / $32.36	Professional		$8.91	$18.62	$32.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $38.02 / $125.89	Facility		$26.30	$38.02	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $61.66	Professional		$20.42	$32.36	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.18 / $22.91	Professional	26	$7.59	$13.18	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $17.78 / $40.74	Professional	TC	$11.48	$17.78	$40.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.90 / $67.61	Professional		$25.70	$30.90	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.96 / $21.88	Professional	26	$8.51	$10.96	$21.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $44.67	Professional	TC	$17.38	$21.38	$44.67
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $6,025.60	Facility		$1,318.26	$1,318.26	$6,025.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $23.44 / $42.66	Professional		$8.71	$23.44	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $218.78 / $218.78	Facility		$12.88	$218.78	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $51.29	Professional		$19.95	$26.92	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.96 / $19.50	Professional	26	$8.32	$10.96	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $16.60 / $33.11	Professional	TC	$10.72	$16.60	$33.11