Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $120.23 / $524.81	Facility		$36.31	$120.23	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $16.60 / $48.98	Facility	26	$9.33	$16.60	$48.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $67.61 / $416.87	Facility	TC	$25.70	$67.61	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.48 / $134.90	Professional		$32.36	$52.48	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.45 / $41.69	Professional	26	$8.91	$14.45	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $79.43 / $194.98	Professional	50	$50.12	$79.43	$194.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.98 / $77.62 / $162.18	Professional	52	$16.98	$77.62	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $60.26	Professional	TC	$22.91	$30.90	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $70.79	Professional		$28.18	$37.15	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.49 / $19.05	Professional	26	$8.32	$13.49	$19.05
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	50	$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $54.95	Professional	TC	$24.55	$30.20	$54.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $70.79 / $100.00	Facility		$33.88	$70.79	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $75.86	Professional		$37.15	$45.71	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $21.88	Professional	26	$10.96	$13.80	$21.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $69.18 / $114.82	Professional	50	$54.95	$69.18	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $31.62 / $53.70	Professional	TC	$25.70	$31.62	$53.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $41.69 / $64.57	Facility		$14.45	$41.69	$64.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $32.36 / $50.12	Professional		$10.96	$32.36	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $67.61 / $263.03	Facility		$47.86	$67.61	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $100.00	Professional		$33.88	$56.23	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $28.84	Professional	26	$9.55	$16.22	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $72.44	Professional	TC	$23.99	$39.81	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $54.95 / $186.21	Professional		$42.66	$54.95	$186.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.13 / $56.23	Professional	26	$10.72	$14.13	$56.23
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $36.31 / $36.31 / $51.29	Professional	52	$36.31	$36.31	$51.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $40.74 / $131.83	Professional	TC	$31.62	$40.74	$131.83
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $117.49 / $218.78	Facility		$102.33	$117.49	$218.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $38.90 / $69.18	Professional		$11.22	$38.90	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $263.03 / $263.03	Facility		$33.11	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $85.11	Professional		$37.15	$47.86	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.49 / $23.99	Professional	26	$10.47	$13.49	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $33.11 / $61.66	Professional	TC	$26.30	$33.11	$61.66