Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $102.33 / $645.65	Facility		$34.67	$102.33	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $18.62 / $44.67	Facility	26	$8.51	$18.62	$44.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $51.29 / $478.63	Facility	TC	$19.50	$51.29	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $46.77 / $125.89	Professional		$26.92	$46.77	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.14 / $39.81	Professional	26	$7.94	$15.14	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.30 / $57.54	Professional	TC	$18.20	$26.30	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.84 / $53.70	Professional		$21.38	$28.84	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.30 / $17.78	Professional	26	$7.76	$12.30	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.39 / $39.81	Professional	TC	$16.60	$22.39	$39.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $56.23 / $75.86	Facility		$28.84	$56.23	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $72.44	Professional		$31.62	$43.65	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.13 / $22.91	Professional	26	$10.23	$14.13	$22.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $48.98	Professional	TC	$21.38	$28.84	$48.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $31.62 / $50.12	Facility		$13.18	$31.62	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $24.55 / $40.74	Professional		$10.00	$24.55	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $51.29 / $263.03	Facility		$36.31	$51.29	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $47.86 / $81.28	Professional		$27.54	$47.86	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.49 / $25.70	Professional	26	$9.77	$15.49	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $56.23	Professional	TC	$19.95	$32.36	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.65 / $117.49	Professional		$33.88	$43.65	$117.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $34.67	Professional	26	$9.77	$13.18	$34.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $97.72	Professional	TC	$23.99	$30.90	$97.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $102.33 / $851.14	Facility		$89.13	$102.33	$851.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $30.90 / $52.48	Professional		$10.23	$30.90	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $263.03 / $263.03	Facility		$29.51	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $70.79	Professional		$30.20	$38.90	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.30 / $22.91	Professional	26	$9.55	$12.30	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.92 / $47.86	Professional	TC	$20.42	$26.92	$47.86