Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $102.33 / $457.09	Facility		$41.69	$102.33	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $15.49 / $38.02	Facility	26	$7.24	$15.49	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $43.65 / $251.19	Facility	TC	$19.95	$43.65	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $46.77 / $125.89	Professional		$25.70	$46.77	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $30.20	Professional	26	$7.08	$11.75	$30.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.30 / $53.70	Professional	TC	$18.20	$26.30	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $60.26	Professional		$22.91	$33.88	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.00 / $14.79	Professional	26	$6.92	$10.00	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $21.88 / $38.90	Professional	TC	$18.20	$21.88	$38.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $51.29 / $79.43	Facility		$25.70	$51.29	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $37.15 / $64.57	Professional		$27.54	$37.15	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $19.05	Professional	26	$8.32	$11.48	$19.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.30 / $46.77	Professional	TC	$19.50	$26.30	$46.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $33.11 / $51.29	Facility		$11.48	$33.11	$51.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $25.70 / $39.81	Professional		$8.51	$25.70	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $53.70 / $158.49	Facility		$37.15	$53.70	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $77.62	Professional		$26.30	$41.69	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $21.88	Professional	26	$7.59	$12.30	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $57.54	Professional	TC	$19.05	$30.20	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $102.33	Professional		$32.36	$42.66	$102.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $30.20	Professional	26	$8.51	$11.48	$30.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $31.62 / $83.18	Professional	TC	$23.99	$31.62	$83.18
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $660.69 / $660.69	Facility		$151.36	$660.69	$660.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $26.92 / $53.70	Professional		$8.71	$26.92	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $218.78 / $218.78	Facility		$26.30	$218.78	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $67.61	Professional		$28.84	$36.31	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $18.20	Professional	26	$7.94	$10.00	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.70 / $47.86	Professional	TC	$19.95	$25.70	$47.86