Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.56 / $213.00 / $522.26	Facility		$43.56	$213.00	$522.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.29 / $11.12 / $37.15	Facility	26	$7.29	$11.12	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.16 / $104.63 / $423.90	Facility	TC	$20.16	$104.63	$423.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.10 / $34.85 / $97.99	Professional		$15.10	$34.85	$97.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $12.33 / $36.38	Professional	26	$7.30	$12.33	$36.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.06 / $151.04 / $228.00	Professional	50	$51.06	$151.04	$228.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.63 / $26.62 / $58.57	Professional	TC	$18.63	$26.62	$58.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.37 / $42.19 / $54.99	Professional		$24.37	$42.19	$54.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $11.40 / $15.08	Professional	26	$6.50	$11.40	$15.08
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $60.46 / $81.70 / $81.70	Professional	50	$60.46	$81.70	$81.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.86 / $41.74 / $45.04	Professional	TC	$38.86	$41.74	$45.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.88 / $54.97 / $79.15	Facility		$29.88	$54.97	$79.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.30 / $40.60 / $77.56	Professional		$29.30	$40.60	$77.56
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 50 Low / Median / High Price $42.80 / $61.59 / $116.35	Professional	50	$42.80	$61.59	$116.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $28.93 / $57.60	Professional	TC	$20.74	$28.93	$57.60
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 $36.90 / $54.12 / $136.00	Facility		$36.90	$54.12	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $50.13 / $83.44	Professional		$29.62	$50.13	$83.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $13.41 / $22.77	Professional	26	$8.01	$13.41	$22.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $35.92 / $60.72	Professional	TC	$22.05	$35.92	$60.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.88 / $55.61 / $116.59	Professional		$34.88	$55.61	$116.59
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 / $86.73	Professional	TC	$25.94	$41.35	$86.73
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,069.89 / $1,663.61 / $1,750.00	Facility		$1,069.89	$1,663.61	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.37 / $33.29 / $58.66	Professional		$11.37	$33.29	$58.66
United Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $40.94 / $68.77	Professional		$29.19	$40.94	$68.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.86 / $19.23	Professional	26	$7.95	$10.86	$19.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.24 / $30.44 / $51.26	Professional	TC	$21.24	$30.44	$51.26