Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.55 / $107.50 / $536.52	Facility		$45.55	$107.50	$536.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $13.63 / $47.54	Facility	26	$9.34	$13.63	$47.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.25 / $111.28 / $635.44	Facility	TC	$24.25	$111.28	$635.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $47.42 / $151.88	Professional		$31.62	$47.42	$151.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $15.06 / $30.91	Professional	26	$9.26	$15.06	$30.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.66 / $31.24 / $77.53	Professional	TC	$22.66	$31.24	$77.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $50.72 / $66.81	Professional		$29.56	$50.72	$66.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $14.57 / $19.27	Professional	26	$8.36	$14.57	$19.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $46.29 / $49.74	Professional	TC	$25.66	$46.29	$49.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.43 / $64.70 / $94.35	Facility		$34.43	$64.70	$94.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.94 / $46.97 / $93.61	Professional		$32.94	$46.97	$93.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $14.60 / $28.57	Professional	26	$9.82	$14.60	$28.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.15 / $32.42 / $67.70	Professional	TC	$22.15	$32.42	$67.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.13 / $34.90 / $53.87	Facility		$13.13	$34.90	$53.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $30.86 / $56.59	Professional		$10.96	$30.86	$56.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.97 / $63.62 / $136.00	Facility		$42.97	$63.62	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.68 / $56.00 / $94.28	Professional		$32.68	$56.00	$94.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.37 / $28.85	Professional	26	$10.23	$17.37	$28.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $38.88 / $69.72	Professional	TC	$22.89	$38.88	$69.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.33 / $67.48 / $141.47	Professional		$42.33	$67.48	$141.47
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 $30.91 / $49.28 / $103.33	Professional	TC	$30.91	$49.28	$103.33
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $145.84 / $175.19 / $1,224.59	Facility		$145.84	$175.19	$1,224.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $39.19 / $66.63	Professional		$13.64	$39.19	$66.63
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 $33.40 / $46.38 / $82.51	Professional		$33.40	$46.38	$82.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $13.85 / $23.10	Professional	26	$9.93	$13.85	$23.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.73 / $32.72 / $57.73	Professional	TC	$22.73	$32.72	$57.73