Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.16 / $166.91 / $522.26	Facility		$50.16	$166.91	$522.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $10.64 / $47.54	Facility	26	$9.34	$10.64	$47.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.39 / $180.76 / $538.72	Facility	TC	$30.39	$180.76	$538.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.84 / $43.40 / $138.86	Professional		$10.84	$43.40	$138.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $12.72 / $48.00	Professional	26	$9.35	$12.72	$48.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $34.43 / $94.12	Professional	TC	$27.55	$34.43	$94.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $56.47 / $79.90	Professional		$35.26	$56.47	$79.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $14.57 / $19.27	Professional	26	$8.36	$14.57	$19.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $60.70 / $66.54	Professional	TC	$41.31	$60.70	$66.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.02 / $80.48 / $118.20	Facility		$44.02	$80.48	$118.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $53.34 / $111.36	Professional		$38.85	$53.34	$111.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $13.84 / $25.37	Professional	26	$9.86	$13.84	$25.37
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.96 / $80.01 / $167.10	Professional	50	$57.96	$80.01	$167.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.46 / $41.35 / $86.35	Professional	TC	$27.46	$41.35	$86.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.13 / $44.49 / $64.70	Facility		$13.13	$44.49	$64.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $39.38 / $70.56	Professional		$10.96	$39.38	$70.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.76 / $81.14 / $136.00	Facility		$53.76	$81.14	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $41.38	Facility	TC	$41.38	$41.38	$41.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.20 / $64.77 / $115.41	Professional		$40.20	$64.77	$115.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $17.20 / $29.46	Professional	26	$10.93	$17.20	$29.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $48.68 / $89.04	Professional	TC	$29.11	$48.68	$89.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.35 / $58.56 / $169.94	Professional		$10.35	$58.56	$169.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $14.95 / $41.83	Professional	26	$10.35	$14.95	$41.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $10.35 / $44.49 / $131.77	Professional	TC	$10.35	$44.49	$131.77
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $930.61 / $1,663.61 / $2,164.00	Facility		$930.61	$1,663.61	$2,164.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.55 / $49.88 / $81.34	Professional		$14.55	$49.88	$81.34
United Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $54.91 / $97.80	Professional		$41.18	$54.91	$97.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.63 / $14.22 / $24.66	Professional	26	$10.63	$14.22	$24.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $38.67 / $75.06	Professional	TC	$30.09	$38.67	$75.06