Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.59 / $154.86 / $478.40	Facility		$36.59	$154.86	$478.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.00 / $10.47 / $35.68	Facility	26	$7.00	$10.47	$35.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.45 / $84.75 / $603.67	Facility	TC	$20.45	$84.75	$603.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.33 / $29.83 / $81.99	Professional		$12.33	$29.83	$81.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $11.07 / $35.78	Professional	26	$6.90	$11.07	$35.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.06 / $53.02	Professional	TC	$18.82	$23.06	$53.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $28.77 / $57.67	Professional		$23.87	$28.77	$57.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $10.51 / $14.29	Professional	26	$5.99	$10.51	$14.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.53 / $38.86 / $41.74	Professional	TC	$21.53	$38.86	$41.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.49 / $52.12 / $79.15	Facility		$29.49	$52.12	$79.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $39.79 / $77.19	Professional		$27.77	$39.79	$77.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.22 / $21.41	Professional	26	$7.41	$11.22	$21.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $28.13 / $57.02	Professional	TC	$18.82	$28.13	$57.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.46 / $29.30 / $43.48	Facility		$9.46	$29.30	$43.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $25.90 / $47.48	Professional		$7.83	$25.90	$47.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.79 / $53.39 / $136.00	Facility		$35.79	$53.39	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
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 $27.05 / $45.67 / $83.44	Professional		$27.05	$45.67	$83.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $13.39 / $21.76	Professional	26	$7.93	$13.39	$21.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $33.17 / $60.72	Professional	TC	$19.14	$33.17	$60.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $54.47 / $114.19	Professional		$34.17	$54.47	$114.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $13.12 / $29.53	Professional	26	$8.23	$13.12	$29.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.94 / $41.35 / $86.71	Professional	TC	$25.94	$41.35	$86.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $506.15 / $1,261.90 / $1,274.00	Facility		$506.15	$1,261.90	$1,274.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.76 / $32.65 / $57.46	Professional		$10.76	$32.65	$57.46
United Facility/Professional Professional Modifier Low / Median / High Price $29.04 / $38.14 / $68.80	Professional		$29.04	$38.14	$68.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.39 / $19.00	Professional	26	$7.79	$10.39	$19.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $28.22 / $50.57	Professional	TC	$20.79	$28.22	$50.57