Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $180.76 / $522.26	Facility		$32.86	$180.76	$522.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.70 / $9.77 / $35.68	Facility	26	$6.70	$9.77	$35.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.11 / $167.24 / $522.26	Facility	TC	$18.11	$167.24	$522.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.87 / $30.11 / $100.08	Professional		$12.87	$30.11	$100.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $11.72 / $36.84	Professional	26	$6.71	$11.72	$36.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $140.76 / $145.24 / $253.54	Professional	50	$140.76	$145.24	$253.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $21.73 / $49.56	Professional	TC	$16.67	$21.73	$49.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $42.61 / $52.88	Professional		$21.93	$42.61	$52.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $10.51 / $13.89	Professional	26	$5.99	$10.51	$13.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.61 / $34.61 / $34.61	Professional	TC	$34.61	$34.61	$34.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.01 / $48.69 / $70.50	Facility		$27.01	$48.69	$70.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $36.29 / $71.05	Professional		$25.11	$36.29	$71.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $10.51 / $21.41	Professional	26	$7.16	$10.51	$21.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.72 / $54.75 / $108.34	Professional	50	$37.72	$54.75	$108.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $25.24 / $50.79	Professional	TC	$17.23	$25.24	$50.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.46 / $26.10 / $39.86	Facility		$9.46	$26.10	$39.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $23.06 / $42.38	Professional		$7.83	$23.06	$42.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $47.56 / $136.00	Facility		$32.79	$47.56	$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 $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $42.05 / $74.80	Professional		$24.98	$42.05	$74.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $12.82 / $21.22	Professional	26	$7.38	$12.82	$21.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $29.89 / $53.87	Professional	TC	$17.78	$29.89	$53.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.33 / $49.94 / $104.71	Professional		$31.33	$49.94	$104.71
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 $23.10 / $36.83 / $77.23	Professional	TC	$23.10	$36.83	$77.23
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $223.13 / $268.02 / $427.47	Facility		$223.13	$268.02	$427.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.54 / $29.90 / $52.69	Professional		$10.54	$29.90	$52.69
United Facility/Professional Facility Modifier Low / Median / High Price $179.57 / $216.45 / $216.45	Facility		$179.57	$216.45	$216.45
United Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $35.77 / $64.01	Professional		$26.23	$35.77	$64.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $10.35 / $18.46	Professional	26	$7.36	$10.35	$18.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.47 / $24.62 / $45.01	Professional	TC	$18.47	$24.62	$45.01