Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $758.58 / $1,071.52	Facility		$53.70	$758.58	$1,071.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $58.88 / $138.04	Facility	26	$26.30	$58.88	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $85.11 / $331.13	Professional		$47.86	$85.11	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $44.67 / $147.91	Professional	26	$25.70	$44.67	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $169.82	Professional	TC	$20.89	$31.62	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $114.82	Professional		$42.66	$51.29	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $37.15 / $56.23	Professional	26	$23.99	$37.15	$56.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $28.18	Professional	TC	$28.18	$28.18	$28.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $91.20 / $371.54	Facility		$36.31	$91.20	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $158.49 / $263.03	Professional		$64.57	$158.49	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $43.65 / $75.86	Professional	26	$30.90	$43.65	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $89.13 / $208.93	Professional	TC	$29.51	$89.13	$208.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $46.77 / $91.20	Facility		$35.48	$46.77	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $36.31 / $69.18	Professional		$26.92	$36.31	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $58.88 / $316.23	Facility		$41.69	$58.88	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $125.89 / $302.00	Professional		$54.95	$125.89	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $81.28	Professional	26	$30.20	$45.71	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $63.10 / $251.19	Professional	TC	$25.12	$63.10	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $380.19	Professional		$64.57	$77.62	$380.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $38.02 / $117.49	Professional	26	$31.62	$38.02	$117.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $39.81 / $331.13	Professional	TC	$33.11	$39.81	$331.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $16,595.87 / $26,915.35	Facility		$7,585.78	$16,595.87	$26,915.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $56.23 / $117.49	Professional		$31.62	$56.23	$117.49
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $102.33 / $154.88	Facility		$37.15	$102.33	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $100.00 / $234.42	Professional		$56.23	$100.00	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $66.07	Professional	26	$29.51	$39.81	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $44.67 / $190.55	Professional	TC	$24.55	$44.67	$190.55