Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.95 / $111.35 / $411.58	Facility		$33.95	$111.35	$411.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.58 / $8.65 / $38.65	Facility	26	$7.58	$8.65	$38.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.82 / $167.24 / $541.36	Facility	TC	$17.82	$167.24	$541.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.44 / $33.95 / $90.13	Professional		$24.44	$33.95	$90.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.55 / $37.54	Professional	26	$7.59	$9.55	$37.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $20.04 / $48.29	Professional	TC	$16.39	$20.04	$48.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.56 / $38.47 / $54.08	Professional		$22.56	$38.47	$54.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.10 / $13.62 / $16.12	Professional	26	$7.10	$13.62	$16.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $34.09 / $38.39	Professional	TC	$18.87	$34.09	$38.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.00 / $48.20 / $69.40	Facility		$27.00	$48.20	$69.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.41 / $33.97 / $70.95	Professional		$25.41	$33.97	$70.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $11.24 / $20.35	Professional	26	$8.10	$11.24	$20.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.68 / $24.23 / $50.61	Professional	TC	$16.68	$24.23	$50.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.69 / $25.70 / $40.78	Facility		$10.69	$25.70	$40.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.88 / $22.71 / $41.74	Professional		$8.88	$22.71	$41.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $47.56 / $127.31	Facility		$33.92	$47.56	$127.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $42.00 / $76.68	Professional		$26.69	$42.00	$76.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.97 / $13.94 / $23.89	Professional	26	$8.97	$13.94	$23.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.59 / $28.99 / $53.04	Professional	TC	$17.59	$28.99	$53.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $8.44 / $34.96 / $107.10	Professional		$8.44	$34.96	$107.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.15 / $31.05	Professional	26	$9.27	$12.15	$31.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.75 / $29.78 / $76.05	Professional	TC	$22.75	$29.78	$76.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $770.01 / $1,663.61 / $2,164.00	Facility		$770.01	$1,663.61	$2,164.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.82 / $30.33 / $52.43	Professional		$11.82	$30.33	$52.43
United Facility/Professional Professional Modifier Low / Median / High Price $26.63 / $35.06 / $63.16	Professional		$26.63	$35.06	$63.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $11.76 / $20.58	Professional	26	$8.61	$11.76	$20.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.86 / $24.20 / $44.18	Professional	TC	$17.86	$24.20	$44.18