Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $199.53 / $588.84	Facility		$36.31	$199.53	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $12.02 / $35.48	Facility	26	$6.76	$12.02	$35.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $89.13 / $660.69	Facility	TC	$19.95	$89.13	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $33.11 / $102.33	Professional		$10.23	$33.11	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $13.18 / $40.74	Professional	26	$6.76	$13.18	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $107.15 / $162.18	Professional	50	$45.71	$107.15	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $28.84 / $60.26	Professional	TC	$17.38	$28.84	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.84 / $53.70	Professional		$20.89	$28.84	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.41 / $12.59	Professional	26	$6.03	$7.41	$12.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $56.23 / $181.97	Professional	50	$37.15	$56.23	$181.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.12 / $39.81	Professional	TC	$19.05	$25.12	$39.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $44.67 / $77.62	Facility		$23.99	$44.67	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $61.66	Professional		$26.30	$37.15	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $18.20	Professional	26	$7.94	$11.22	$18.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $54.95 / $95.50	Professional	50	$38.90	$54.95	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.12 / $45.71	Professional	TC	$17.78	$25.12	$45.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $31.62 / $50.12	Facility		$10.47	$31.62	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $25.70 / $38.90	Professional		$7.94	$25.70	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $52.48 / $158.49	Facility		$38.02	$52.48	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $40.74 / $75.86	Professional		$25.12	$40.74	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $20.42	Professional	26	$7.08	$11.75	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $29.51 / $57.54	Professional	TC	$18.20	$29.51	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $104.71	Professional		$31.62	$41.69	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.47 / $27.54	Professional	26	$7.76	$10.47	$27.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $31.62 / $77.62	Professional	TC	$23.99	$31.62	$77.62
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $5,128.61	Facility		$1,412.54	$1,412.54	$5,128.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $26.92 / $52.48	Professional		$7.94	$26.92	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $218.78 / $218.78	Facility		$23.44	$218.78	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.88 / $63.10	Professional		$26.92	$33.88	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.77 / $17.38	Professional	26	$7.41	$9.77	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.55 / $45.71	Professional	TC	$19.05	$24.55	$45.71