Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $190.55 / $489.78	Facility		$35.48	$190.55	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $10.96 / $36.31	Facility	26	$6.76	$10.96	$36.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $79.43 / $524.81	Facility	TC	$18.20	$79.43	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $32.36 / $100.00	Professional		$12.88	$32.36	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $12.88 / $38.02	Professional	26	$6.61	$12.88	$38.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.49 / $141.25 / $281.84	Professional	50	$15.49	$141.25	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $54.95	Professional	TC	$16.98	$25.70	$54.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $24.55 / $48.98	Professional		$18.20	$24.55	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.12 / $13.49	Professional	26	$6.03	$9.12	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $79.43 / $85.11	Professional	50	$50.12	$79.43	$85.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $22.39 / $36.31	Professional	TC	$14.79	$22.39	$36.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $46.77 / $70.79	Facility		$25.12	$46.77	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $58.88	Professional		$25.70	$33.88	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.47 / $17.78	Professional	26	$7.59	$10.47	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $51.29 / $89.13	Professional	50	$38.02	$51.29	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.44 / $42.66	Professional	TC	$17.78	$23.44	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $29.51 / $45.71	Facility		$10.47	$29.51	$45.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.91 / $35.48	Professional		$7.94	$22.91	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $47.86 / $158.49	Facility		$33.11	$47.86	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.02 / $69.18	Professional		$23.44	$38.02	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $20.89	Professional	26	$7.08	$11.48	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.92 / $51.29	Professional	TC	$17.38	$26.92	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.02 / $93.33	Professional		$29.51	$38.02	$93.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.47 / $28.18	Professional	26	$7.76	$10.47	$28.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $75.86	Professional	TC	$21.88	$28.18	$75.86
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $1,148.15	Facility		$467.74	$562.34	$1,148.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $26.92 / $48.98	Professional		$7.94	$26.92	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $218.78 / $218.78	Facility		$23.44	$218.78	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $61.66	Professional		$26.30	$33.11	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.55 / $17.38	Professional	26	$7.24	$9.55	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $43.65	Professional	TC	$18.20	$23.44	$43.65