Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $173.78 / $588.84	Facility		$45.71	$173.78	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $12.59 / $40.74	Facility	26	$7.94	$12.59	$40.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $104.71 / $630.96	Facility	TC	$22.39	$104.71	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $38.90 / $112.20	Professional		$9.12	$38.90	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $43.65	Professional	26	$7.94	$12.88	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $93.33 / $199.53	Professional	50	$30.20	$93.33	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $85.11	Professional	TC	$19.95	$36.31	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.90 / $57.54	Professional		$21.88	$30.90	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.77 / $16.22	Professional	26	$7.08	$9.77	$16.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $63.10 / $89.13	Professional	50	$37.15	$63.10	$89.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.12 / $45.71	Professional	TC	$17.78	$25.12	$45.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $50.12 / $83.18	Facility		$26.30	$50.12	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $67.61	Professional		$28.84	$38.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $20.89	Professional	26	$8.91	$12.02	$20.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $58.88 / $102.33	Professional	50	$42.66	$58.88	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $47.86	Professional	TC	$19.50	$26.92	$47.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $34.67 / $54.95	Facility		$12.30	$34.67	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $27.54 / $42.66	Professional		$9.33	$27.54	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $57.54 / $158.49	Facility		$38.90	$57.54	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $43.65 / $83.18	Professional		$26.92	$43.65	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.49 / $23.44	Professional	26	$8.13	$13.49	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $60.26	Professional	TC	$19.50	$30.90	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $104.71	Professional		$36.31	$46.77	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $32.36	Professional	26	$9.12	$12.30	$32.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $35.48 / $85.11	Professional	TC	$26.92	$35.48	$85.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $2,454.71	Facility		$1,288.25	$1,288.25	$2,454.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $33.11 / $58.88	Professional		$9.55	$33.11	$58.88
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 $29.51 / $37.15 / $70.79	Professional		$29.51	$37.15	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $19.95	Professional	26	$8.32	$10.72	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.30 / $50.12	Professional	TC	$20.42	$26.30	$50.12