Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.24 / $137.34 / $561.00	Facility		$39.24	$137.34	$561.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.58 / $8.65 / $38.65	Facility	26	$7.58	$8.65	$38.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.50 / $153.97 / $650.12	Facility	TC	$22.50	$153.97	$650.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.81 / $32.24 / $102.68	Professional		$8.81	$32.24	$102.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.52 / $40.26	Professional	26	$7.59	$12.52	$40.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $161.30 / $176.48 / $322.60	Professional	50	$161.30	$176.48	$322.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.73 / $24.79 / $60.01	Professional	TC	$20.73	$24.79	$60.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.25 / $46.13 / $64.26	Professional		$23.25	$46.13	$64.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $12.29 / $16.12	Professional	26	$6.99	$12.29	$16.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.63 / $42.47 / $96.48	Professional	TC	$36.63	$42.47	$96.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.89 / $60.14 / $87.84	Facility		$32.89	$60.14	$87.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $40.14 / $83.38	Professional		$30.40	$40.14	$83.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $11.63 / $21.28	Professional	26	$8.36	$11.63	$21.28
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.45 / $60.21 / $126.10	Professional	50	$45.45	$60.21	$126.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $30.19 / $63.04	Professional	TC	$21.00	$30.19	$63.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.69 / $32.49 / $48.45	Facility		$10.69	$32.49	$48.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.88 / $28.74 / $52.73	Professional		$8.88	$28.74	$52.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $59.25 / $136.00	Facility		$39.89	$59.25	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.48 / $49.52 / $90.73	Professional		$31.48	$49.52	$90.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $14.49 / $24.77	Professional	26	$9.22	$14.49	$24.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $36.13 / $67.09	Professional	TC	$22.08	$36.13	$67.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $60.69 / $217.00	Professional		$38.07	$60.69	$217.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $14.80 / $65.09	Professional	26	$9.27	$14.80	$65.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $45.87 / $151.90	Professional	TC	$28.78	$45.87	$151.90
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $195.33 / $280.06 / $639.30	Facility		$195.33	$280.06	$639.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.05 / $36.36 / $64.19	Professional		$12.05	$36.36	$64.19
United Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $44.17 / $74.48	Professional		$31.46	$44.17	$74.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $12.19 / $19.98	Professional	26	$8.85	$12.19	$19.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $30.07 / $54.91	Professional	TC	$22.40	$30.07	$54.91