Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $181.97 / $537.03	Facility		$45.71	$181.97	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $12.59 / $37.15	Facility	26	$7.08	$12.59	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $154.88 / $501.19	Facility	TC	$22.91	$154.88	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $43.65 / $125.89	Professional		$10.72	$43.65	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $44.67	Professional	26	$7.08	$14.13	$44.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.18 / $85.11 / $199.53	Professional	50	$28.18	$85.11	$199.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $3.80	Professional	52	$3.80	$3.80	$3.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $39.81 / $89.13	Professional	TC	$20.89	$39.81	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $30.20 / $56.23	Professional		$22.39	$30.20	$56.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.51 / $14.13	Professional	26	$6.17	$8.51	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $56.23 / $91.20	Professional	50	$36.31	$56.23	$91.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $24.55 / $44.67	Professional	TC	$17.78	$24.55	$44.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $53.70 / $85.11	Facility		$29.51	$53.70	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.02 / $67.61	Professional		$28.84	$38.02	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $18.62	Professional	26	$7.94	$11.22	$18.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $56.23 / $102.33	Professional	50	$42.66	$56.23	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.30 / $50.12	Professional	TC	$20.42	$26.30	$50.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $34.67 / $53.70	Facility		$10.96	$34.67	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $27.54 / $41.69	Professional		$8.32	$27.54	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $57.54 / $158.49	Facility		$38.90	$57.54	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $43.65 / $79.43	Professional		$26.92	$43.65	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $12.02 / $21.38	Professional	26	$7.24	$12.02	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $32.36 / $61.66	Professional	TC	$20.42	$32.36	$61.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $104.71	Professional		$34.67	$44.67	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.96 / $30.20	Professional	26	$8.13	$10.96	$30.20
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $30.20 / $42.66	Professional	52	$30.20	$30.20	$42.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $34.67 / $77.62	Professional	TC	$26.30	$34.67	$77.62
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $107.15 / $741.31	Facility		$93.33	$107.15	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $31.62 / $56.23	Professional		$8.51	$31.62	$56.23
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 $28.18 / $37.15 / $66.07	Professional		$28.18	$37.15	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.77 / $17.78	Professional	26	$7.76	$9.77	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.92 / $48.98	Professional	TC	$20.42	$26.92	$48.98