Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.43 / $211.04 / $854.70	Facility		$39.43	$211.04	$854.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.58 / $8.65 / $38.65	Facility	26	$7.58	$8.65	$38.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.31 / $167.45 / $300.97	Facility	TC	$14.31	$167.45	$300.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.01 / $26.26 / $79.75	Professional		$19.01	$26.26	$79.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $8.99 / $38.18	Professional	26	$7.58	$8.99	$38.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $14.41 / $32.76	Professional	TC	$10.66	$14.41	$32.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.53 / $31.21 / $44.16	Professional		$19.53	$31.21	$44.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $12.29 / $16.12	Professional	26	$6.76	$12.29	$16.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $27.72 / $29.59	Professional	TC	$19.41	$27.72	$29.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.51 / $38.15 / $56.39	Facility		$16.51	$38.15	$56.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $28.35 / $60.07	Professional		$19.36	$28.35	$60.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.05 / $11.24 / $19.98	Professional	26	$8.05	$11.24	$19.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.81 / $17.91 / $40.50	Professional	TC	$11.81	$17.91	$40.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.69 / $20.90 / $35.36	Facility		$10.69	$20.90	$35.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.88 / $19.03 / $33.97	Professional		$8.88	$19.03	$33.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.22 / $38.06 / $127.31	Facility		$25.22	$38.06	$127.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.32 / $33.72 / $61.88	Professional		$20.32	$33.72	$61.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $13.94 / $24.65	Professional	26	$8.88	$13.94	$24.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.08 / $18.57 / $41.72	Professional	TC	$11.08	$18.57	$41.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.81 / $30.31 / $92.85	Professional		$23.81	$30.31	$92.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.15 / $31.04	Professional	26	$9.27	$12.15	$31.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $24.21 / $61.80	Professional	TC	$18.48	$24.21	$61.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,975.76 / $2,123.17 / $2,932.00	Facility		$1,975.76	$2,123.17	$2,932.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.97 / $24.57 / $42.66	Professional		$10.97	$24.57	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $179.57 / $216.45 / $216.45	Facility		$179.57	$216.45	$216.45
United Facility/Professional Professional Modifier Low / Median / High Price $20.28 / $28.58 / $55.29	Professional		$20.28	$28.58	$55.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $11.76 / $20.58	Professional	26	$8.61	$11.76	$20.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.36 / $17.25 / $35.29	Professional	TC	$11.36	$17.25	$35.29