Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.11 / $99.69 / $550.67	Facility		$37.11	$99.69	$550.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.00 / $11.87 / $35.68	Facility	26	$7.00	$11.87	$35.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.74 / $42.78 / $404.50	Facility	TC	$20.74	$42.78	$404.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.39 / $33.28 / $110.10	Professional		$16.39	$33.28	$110.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $11.89 / $35.60	Professional	26	$6.97	$11.89	$35.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.92 / $163.13 / $320.24	Professional	50	$109.92	$163.13	$320.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.92 / $14.02 / $40.01	Professional	52	$11.92	$14.02	$40.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $22.68 / $50.11	Professional	TC	$18.53	$22.68	$50.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $38.04 / $57.67	Professional		$23.87	$38.04	$57.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $10.51 / $13.89	Professional	26	$5.99	$10.51	$13.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $86.50 / $86.50 / $186.97	Professional	50	$86.50	$86.50	$186.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.86 / $38.86 / $38.86	Professional	TC	$38.86	$38.86	$38.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.47 / $51.56 / $80.23	Facility		$27.47	$51.56	$80.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $37.65 / $76.13	Professional		$25.15	$37.65	$76.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $10.84 / $21.41	Professional	26	$7.16	$10.84	$21.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.29 / $57.36 / $117.10	Professional	50	$37.29	$57.36	$117.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $27.58 / $57.60	Professional	TC	$17.82	$27.58	$57.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.46 / $29.30 / $43.48	Facility		$9.46	$29.30	$43.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $25.90 / $47.48	Professional		$7.83	$25.90	$47.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.15 / $54.12 / $136.00	Facility		$36.15	$54.12	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $44.39 / $80.36	Professional		$25.77	$44.39	$80.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $12.87 / $21.22	Professional	26	$7.38	$12.87	$21.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $31.62 / $61.31	Professional	TC	$18.78	$31.62	$61.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $54.47 / $114.20	Professional		$34.17	$54.47	$114.20
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 52 Low / Median / High Price $28.44 / $28.44 / $39.97	Professional	52	$28.44	$28.44	$39.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.94 / $41.35 / $86.73	Professional	TC	$25.94	$41.35	$86.73
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $206.44 / $229.40 / $275.56	Facility		$206.44	$229.40	$275.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.67 / $33.65 / $55.40	Professional		$10.67	$33.65	$55.40
United Facility/Professional Facility Modifier Low / Median / High Price $79.81 / $216.45 / $216.45	Facility		$79.81	$216.45	$216.45
United Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $38.35 / $67.30	Professional		$28.08	$38.35	$67.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $10.35 / $17.87	Professional	26	$7.28	$10.35	$17.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $27.78 / $51.34	Professional	TC	$18.73	$27.78	$51.34