Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.45 / $180.76 / $530.40	Facility		$36.45	$180.76	$530.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.70 / $9.82 / $34.15	Facility	26	$6.70	$9.82	$34.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.16 / $180.76 / $616.04	Facility	TC	$20.16	$180.76	$616.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.52 / $30.37 / $107.74	Professional		$8.52	$30.37	$107.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $10.87 / $37.54	Professional	26	$6.71	$10.87	$37.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.28 / $151.94 / $299.07	Professional	50	$115.28	$151.94	$299.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $22.96 / $55.71	Professional	TC	$17.57	$22.96	$55.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $46.59 / $57.07	Professional		$23.63	$46.59	$57.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.29 / $10.88 / $13.89	Professional	26	$6.29	$10.88	$13.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $62.78 / $62.78 / $62.78	Professional	50	$62.78	$62.78	$62.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.71 / $36.71 / $84.58	Professional	TC	$36.71	$36.71	$84.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.60 / $49.94 / $78.09	Facility		$27.60	$49.94	$78.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $37.69 / $75.44	Professional		$26.22	$37.69	$75.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.89 / $21.00	Professional	26	$7.41	$10.89	$21.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.33 / $57.64 / $115.02	Professional	50	$39.33	$57.64	$115.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $26.84 / $56.04	Professional	TC	$17.66	$26.84	$56.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.46 / $28.90 / $43.04	Facility		$9.46	$28.90	$43.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $25.55 / $46.91	Professional		$7.83	$25.55	$46.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $52.67 / $136.00	Facility		$35.40	$52.67	$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 $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $43.07 / $80.59	Professional		$25.36	$43.07	$80.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $12.95 / $21.22	Professional	26	$7.93	$12.95	$21.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $30.91 / $59.66	Professional	TC	$18.32	$30.91	$59.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $53.91 / $113.01	Professional		$33.81	$53.91	$113.01
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 $25.59 / $40.79 / $85.52	Professional	TC	$25.59	$40.79	$85.52
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,163.74 / $1,305.08 / $2,164.00	Facility		$1,163.74	$1,305.08	$2,164.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $32.56 / $57.12	Professional		$10.80	$32.56	$57.12
United Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $37.11 / $66.05	Professional		$27.10	$37.11	$66.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.78 / $17.72	Professional	26	$7.79	$10.78	$17.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.86 / $26.32 / $48.80	Professional	TC	$18.86	$26.32	$48.80