Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.40 / $181.10 / $389.64	Facility		$32.40	$181.10	$389.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.00 / $10.41 / $35.68	Facility	26	$7.00	$10.41	$35.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.82 / $158.65 / $544.59	Facility	TC	$17.82	$158.65	$544.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.11 / $28.51 / $99.76	Professional		$14.11	$28.51	$99.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $12.87 / $36.06	Professional	26	$6.81	$12.87	$36.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.26 / $113.44 / $145.24	Professional	50	$54.26	$113.44	$145.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $21.38 / $49.10	Professional	TC	$16.39	$21.38	$49.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.78 / $43.22 / $52.88	Professional		$22.78	$43.22	$52.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $10.93 / $14.90	Professional	26	$5.97	$10.93	$14.90
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.45 / $56.33 / $79.31	Professional	50	$52.45	$56.33	$79.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.64 / $38.39 / $38.39	Professional	TC	$32.64	$38.39	$38.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.00 / $48.20 / $69.40	Facility		$27.00	$48.20	$69.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $35.85 / $70.18	Professional		$24.95	$35.85	$70.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.55 / $21.41	Professional	26	$7.08	$10.55	$21.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.42 / $54.25 / $106.99	Professional	50	$37.42	$54.25	$106.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $25.24 / $49.90	Professional	TC	$17.51	$25.24	$49.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.84 / $25.70 / $39.86	Facility		$9.84	$25.70	$39.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.16 / $22.71 / $41.74	Professional		$8.16	$22.71	$41.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $46.82 / $136.00	Facility		$32.79	$46.82	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.60 / $41.93 / $74.80	Professional		$24.60	$41.93	$74.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $12.39 / $21.67	Professional	26	$7.19	$12.39	$21.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $31.36 / $53.93	Professional	TC	$18.32	$31.36	$53.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.33 / $49.94 / $104.73	Professional		$31.33	$49.94	$104.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $13.68 / $28.66	Professional	26	$8.58	$13.68	$28.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.75 / $36.26 / $76.03	Professional	TC	$22.75	$36.26	$76.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $408.33 / $445.45 / $1,937.35	Facility		$408.33	$445.45	$1,937.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.92 / $29.68 / $52.69	Professional		$10.92	$29.68	$52.69
United Facility/Professional Facility Modifier Low / Median / High Price $21.17 / $179.57 / $216.45	Facility		$21.17	$179.57	$216.45
United Facility/Professional Professional Modifier Low / Median / High Price $25.81 / $35.54 / $63.22	Professional		$25.81	$35.54	$63.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $9.99 / $17.32	Professional	26	$7.16	$9.99	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.79 / $24.92 / $44.22	Professional	TC	$18.79	$24.92	$44.22