Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.67 / $98.90 / $495.29	Facility		$29.67	$98.90	$495.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.47 / $14.88 / $43.10	Facility	26	$8.47	$14.88	$43.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.28 / $89.03 / $338.63	Facility	TC	$19.28	$89.03	$338.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $39.84 / $95.01	Professional		$26.95	$39.84	$95.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $14.47 / $31.47	Professional	26	$8.47	$14.47	$31.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.75 / $23.80 / $58.18	Professional	TC	$17.75	$23.80	$58.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $39.40 / $59.47	Professional		$24.66	$39.40	$59.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.91 / $13.22 / $17.47	Professional	26	$7.91	$13.22	$17.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $38.46 / $40.04	Professional	TC	$20.64	$38.46	$40.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.92 / $55.54 / $75.91	Facility		$28.92	$55.54	$75.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.29 / $44.26 / $79.34	Professional		$30.29	$44.26	$79.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.18 / $26.40	Professional	26	$9.33	$14.18	$26.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $29.37 / $55.97	Professional	TC	$20.35	$29.37	$55.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.91 / $28.10 / $44.84	Facility		$11.91	$28.10	$44.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.91 / $24.84 / $45.61	Professional		$9.91	$24.84	$45.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.60 / $51.19 / $171.35	Facility		$36.60	$51.19	$171.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.94 / $85.31	Professional		$28.84	$50.94	$85.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $16.80 / $28.29	Professional	26	$9.78	$16.80	$28.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $34.72 / $62.84	Professional	TC	$21.52	$34.72	$62.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $56.17 / $118.47	Professional		$35.22	$56.17	$118.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $16.50 / $39.38	Professional	26	$10.35	$16.50	$39.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.88 / $39.67 / $98.04	Professional	TC	$24.88	$39.67	$98.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $175.21 / $210.47 / $287.08	Facility		$175.21	$210.47	$287.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.77 / $31.69 / $55.71	Professional		$12.77	$31.69	$55.71
United Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $42.06 / $70.34	Professional		$30.51	$42.06	$70.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $13.93 / $22.91	Professional	26	$9.88	$13.93	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.56 / $29.13 / $48.49	Professional	TC	$20.56	$29.13	$48.49