Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.00 / $95.27 / $463.27	Facility		$39.00	$95.27	$463.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.35 / $16.64 / $47.54	Facility	26	$9.35	$16.64	$47.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $37.51 / $106.52	Professional		$24.00	$37.51	$106.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $14.19 / $29.19	Professional	26	$9.11	$14.19	$29.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $24.21 / $56.39	Professional	TC	$19.76	$24.21	$56.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $51.15 / $66.06	Professional		$23.95	$51.15	$66.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.07 / $19.27	Professional	26	$8.71	$13.07	$19.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $17.48 / $41.51	Professional	TC	$17.48	$17.48	$41.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.45 / $57.78 / $85.66	Facility		$31.45	$57.78	$85.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.54 / $44.48 / $87.26	Professional		$30.54	$44.48	$87.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $14.57 / $28.57	Professional	26	$9.82	$14.57	$28.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.70 / $29.44 / $61.48	Professional	TC	$19.70	$29.44	$61.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.13 / $31.30 / $49.81	Facility		$13.13	$31.30	$49.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $27.68 / $50.77	Professional		$10.96	$27.68	$50.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.94 / $57.77 / $136.00	Facility		$40.94	$57.77	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $51.06 / $91.41	Professional		$29.64	$51.06	$91.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $17.17 / $28.37	Professional	26	$9.98	$17.17	$28.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $35.34 / $65.06	Professional	TC	$20.72	$35.34	$65.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $62.39 / $130.81	Professional		$39.14	$62.39	$130.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $18.20 / $39.38	Professional	26	$11.42	$18.20	$39.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.72 / $44.19 / $92.66	Professional	TC	$27.72	$44.19	$92.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $145.84 / $175.19 / $287.08	Facility		$145.84	$175.19	$287.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.96 / $37.13 / $65.81	Professional		$14.96	$37.13	$65.81
United Facility/Professional Facility Modifier Low / Median / High Price $70.86 / $179.57 / $185.87	Facility		$70.86	$179.57	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $46.35 / $79.03	Professional		$32.14	$46.35	$79.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $13.79 / $25.31	Professional	26	$9.81	$13.79	$25.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.23 / $28.27 / $52.87	Professional	TC	$21.23	$28.27	$52.87