Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.36 / $187.24 / $524.16	Facility		$45.36	$187.24	$524.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.00 / $10.57 / $34.69	Facility	26	$7.00	$10.57	$34.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.05 / $261.13 / $522.26	Facility	TC	$23.05	$261.13	$522.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.61 / $38.44 / $120.76	Professional		$13.61	$38.44	$120.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $12.40 / $40.00	Professional	26	$6.84	$12.40	$40.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.86 / $84.95 / $197.68	Professional	50	$34.86	$84.95	$197.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.55 / $14.61 / $40.22	Professional	52	$12.55	$14.61	$40.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.75 / $27.24 / $84.95	Professional	TC	$20.75	$27.24	$84.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $43.40 / $61.27	Professional		$26.03	$43.40	$61.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $10.47 / $14.48	Professional	26	$6.44	$10.47	$14.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $65.09 / $78.12 / $91.90	Professional	50	$65.09	$78.12	$91.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.07 / $41.51 / $44.35	Professional	TC	$29.07	$41.51	$44.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.20 / $55.80 / $85.66	Facility		$29.20	$55.80	$85.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.85 / $40.47 / $81.23	Professional		$27.85	$40.47	$81.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $11.27 / $22.04	Professional	26	$7.73	$11.27	$22.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.95 / $61.06 / $122.55	Professional	50	$40.95	$61.06	$122.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.59 / $29.44 / $61.48	Professional	TC	$19.59	$29.44	$61.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.88 / $31.30 / $46.20	Facility		$9.88	$31.30	$46.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.19 / $27.68 / $50.44	Professional		$8.19	$27.68	$50.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $57.77 / $136.00	Facility		$38.40	$57.77	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $47.18 / $84.43	Professional		$27.37	$47.18	$84.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $12.93 / $22.72	Professional	26	$7.93	$12.93	$22.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $35.39 / $63.32	Professional	TC	$20.65	$35.39	$63.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $57.87 / $121.31	Professional		$36.29	$57.87	$121.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $13.68 / $30.51	Professional	26	$8.58	$13.68	$30.51
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $30.21 / $30.21 / $42.46	Professional	52	$30.21	$30.21	$42.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.72 / $44.19 / $92.64	Professional	TC	$27.72	$44.19	$92.64
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $145.84 / $175.19 / $287.08	Facility		$145.84	$175.19	$287.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.13 / $35.36 / $58.92	Professional		$11.13	$35.36	$58.92
United Facility/Professional Facility Modifier Low / Median / High Price $179.57 / $216.45 / $216.45	Facility		$179.57	$216.45	$216.45
United Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $40.58 / $71.45	Professional		$29.06	$40.58	$71.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.65 / $18.46	Professional	26	$7.95	$10.65	$18.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $28.68 / $52.87	Professional	TC	$20.82	$28.68	$52.87