Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.44 / $332.90 / $968.10	Facility		$99.44	$332.90	$968.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.62 / $33.70 / $118.86	Facility	26	$23.62	$33.70	$118.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.58 / $121.69 / $278.50	Professional		$88.58	$121.69	$278.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $36.40 / $76.72	Professional	26	$23.28	$36.40	$76.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.88 / $49.97 / $115.69	Professional	52	$42.88	$49.97	$115.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.95 / $94.28 / $218.46	Professional	TC	$67.95	$94.28	$218.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $129.86 / $196.87	Professional		$81.76	$129.86	$196.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $37.79 / $48.23	Professional	26	$21.42	$37.79	$48.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.84 / $131.80 / $140.91	Professional	TC	$95.84	$131.80	$140.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.73 / $204.76 / $275.42	Facility		$100.73	$204.76	$275.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $134.05 / $257.72	Professional		$89.17	$134.05	$257.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.82 / $35.25 / $63.78	Professional	26	$23.82	$35.25	$63.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.73 / $99.53 / $195.90	Professional	TC	$61.73	$99.53	$195.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.89 / $99.39 / $148.46	Facility		$32.89	$99.39	$148.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $81.05 / $147.80	Professional		$26.71	$81.05	$147.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.09 / $184.10 / $259.52	Facility		$120.09	$184.10	$259.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $30.47 / $30.47	Facility	26	$30.47	$30.47	$30.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.52 / $154.61 / $283.87	Professional		$93.52	$154.61	$283.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.59 / $40.33 / $71.03	Professional	26	$26.59	$40.33	$71.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.38 / $116.42 / $210.14	Professional	TC	$68.38	$116.42	$210.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.04 / $127.25 / $339.72	Professional		$106.04	$127.25	$339.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $33.77 / $81.77	Professional	26	$25.98	$33.77	$81.77
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $97.11 / $97.11 / $136.47	Professional	52	$97.11	$97.11	$136.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $80.06 / $96.07 / $257.95	Professional	TC	$80.06	$96.07	$257.95
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $114.62 / $183.00 / $425.30	Facility		$114.62	$183.00	$425.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $101.58 / $179.00	Professional		$28.10	$101.58	$179.00
United Facility/Professional Facility Modifier Low / Median / High Price $59.20 / $252.18 / $261.88	Facility		$59.20	$252.18	$261.88
United Facility/Professional Professional Modifier Low / Median / High Price $100.14 / $138.04 / $245.60	Professional		$100.14	$138.04	$245.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $34.90 / $59.02	Professional	26	$25.98	$34.90	$59.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.22 / $105.44 / $186.70	Professional	TC	$73.22	$105.44	$186.70