Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.34 / $762.24 / $1,094.09	Facility		$49.34	$762.24	$1,094.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $46.77 / $133.74	Facility	26	$26.26	$46.77	$133.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $77.42 / $244.17	Professional		$48.17	$77.42	$244.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.73 / $38.00 / $88.11	Professional	26	$25.73	$38.00	$88.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $31.59 / $184.73	Professional	TC	$21.27	$31.59	$184.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.93 / $106.09 / $106.42	Professional		$49.93	$106.09	$106.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $52.88 / $54.40	Professional	26	$24.69	$52.88	$54.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.56 / $90.74 / $273.77	Facility		$45.56	$90.74	$273.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.58 / $95.56 / $257.64	Professional		$51.58	$95.56	$257.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $41.19 / $79.04	Professional	26	$26.84	$41.19	$79.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $42.48 / $205.25	Professional	TC	$24.24	$42.48	$205.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.33 / $42.17 / $81.36	Facility		$33.33	$42.17	$81.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $39.79 / $74.62	Professional		$28.10	$39.79	$74.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.15 / $61.60 / $316.00	Facility		$42.15	$61.60	$316.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $122.83 / $324.32	Professional		$57.73	$122.83	$324.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $46.26 / $81.34	Professional	26	$30.83	$46.26	$81.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.15 / $58.77 / $256.92	Professional	TC	$26.15	$58.77	$256.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $74.76 / $376.39	Professional		$57.32	$74.76	$376.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.22 / $39.86 / $124.31	Professional	26	$29.22	$39.86	$124.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $34.90 / $333.53	Professional	TC	$28.10	$34.90	$333.53
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $7,584.00 / $7,584.00 / $14,607.80	Facility		$7,584.00	$7,584.00	$14,607.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $51.26 / $106.23	Professional		$28.30	$51.26	$106.23
United Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $102.32 / $244.31	Professional		$55.55	$102.32	$244.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.46 / $42.58 / $66.33	Professional	26	$30.46	$42.58	$66.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.42 / $45.42 / $188.91	Professional	TC	$25.42	$45.42	$188.91