Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $199.53 / $933.25	Facility		$35.48	$199.53	$933.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $27.54 / $63.10	Facility	26	$11.75	$27.54	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $87.10	Professional		$28.18	$38.90	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.50 / $64.57	Professional	26	$10.96	$19.50	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $50.12	Professional	TC	$16.98	$22.91	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $31.62 / $70.79	Professional		$27.54	$31.62	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.22 / $24.55	Professional	26	$10.47	$16.22	$24.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $51.29 / $83.18	Facility		$26.30	$51.29	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $74.13	Professional		$32.36	$44.67	$74.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $31.62	Professional	26	$14.13	$19.95	$31.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $42.66	Professional	TC	$16.98	$25.12	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $33.11 / $57.54	Facility		$18.20	$33.11	$57.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $26.92 / $45.71	Professional		$13.49	$26.92	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $36.31 / $316.23	Facility		$16.60	$36.31	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $91.20	Professional		$30.90	$47.86	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.42 / $37.15	Professional	26	$13.49	$20.42	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.18 / $56.23	Professional	TC	$17.78	$28.18	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $97.72	Professional		$40.74	$48.98	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.60 / $43.65	Professional	26	$14.13	$16.60	$43.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $31.62 / $91.20	Professional	TC	$26.92	$31.62	$91.20
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $13,803.84 / $17,378.01	Facility		$3,715.35	$13,803.84	$17,378.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $34.67 / $70.79	Professional		$15.14	$34.67	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $19.50 / $39.81	Facility		$17.78	$19.50	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $79.43	Professional		$33.11	$42.66	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.62 / $30.90	Professional	26	$13.80	$18.62	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.55 / $47.86	Professional	TC	$19.05	$24.55	$47.86