Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.23 / $92.79 / $452.40	Facility		$29.23	$92.79	$452.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.30 / $10.92 / $37.15	Facility	26	$7.30	$10.92	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.16 / $38.90 / $280.38	Facility	TC	$20.16	$38.90	$280.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.32 / $41.16 / $111.36	Professional		$26.32	$41.16	$111.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $11.05 / $24.15	Professional	26	$7.30	$11.05	$24.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $23.45 / $54.31	Professional	TC	$18.55	$23.45	$54.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.33 / $41.75 / $58.87	Professional		$21.33	$41.75	$58.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.82 / $11.79 / $15.51	Professional	26	$6.82	$11.79	$15.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $40.10 / $40.10	Professional	TC	$19.91	$40.10	$40.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.93 / $53.07 / $79.15	Facility		$29.93	$53.07	$79.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $39.92 / $77.19	Professional		$27.77	$39.92	$77.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.40 / $22.33	Professional	26	$7.76	$11.40	$22.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $27.30 / $56.82	Professional	TC	$19.02	$27.30	$56.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.27 / $29.30 / $44.39	Facility		$10.27	$29.30	$44.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $25.90 / $47.56	Professional		$8.51	$25.90	$47.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.53 / $53.39 / $136.00	Facility		$36.53	$53.39	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.39 / $45.82 / $83.44	Professional		$27.39	$45.82	$83.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $13.41 / $22.69	Professional	26	$8.01	$13.41	$22.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $33.17 / $60.48	Professional	TC	$19.47	$33.17	$60.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.88 / $55.61 / $116.60	Professional		$34.88	$55.61	$116.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $14.24 / $30.73	Professional	26	$8.93	$14.24	$30.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.94 / $41.35 / $86.70	Professional	TC	$25.94	$41.35	$86.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $149.94 / $180.12 / $742.03	Facility		$149.94	$180.12	$742.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.42 / $33.31 / $58.66	Professional		$11.42	$33.31	$58.66
United Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $38.92 / $69.56	Professional		$29.19	$38.92	$69.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.82 / $19.22	Professional	26	$7.95	$10.82	$19.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $27.23 / $49.77	Professional	TC	$20.42	$27.23	$49.77