Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.64 / $241.55 / $440.55	Facility		$99.64	$241.55	$440.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $46.46 / $117.38	Facility	26	$23.32	$46.46	$117.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $107.29 / $217.23	Professional		$82.68	$107.29	$217.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $34.79 / $72.69	Professional	26	$23.32	$34.79	$72.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.87 / $77.61 / $162.56	Professional	TC	$54.87	$77.61	$162.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $173.89 / $204.58	Professional		$89.88	$173.89	$204.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.58 / $39.20 / $46.12	Professional	26	$20.58	$39.20	$46.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.69 / $183.41 / $292.76	Facility		$79.69	$183.41	$292.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.68 / $129.76 / $270.92	Professional		$79.68	$129.76	$270.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.22 / $33.79 / $69.37	Professional	26	$24.22	$33.79	$69.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.48 / $94.88 / $203.84	Professional	TC	$55.48	$94.88	$203.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.67 / $104.87 / $154.61	Facility		$31.67	$104.87	$154.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $100.41 / $169.71	Professional		$33.20	$100.41	$169.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.81 / $177.53 / $316.00	Facility		$126.81	$177.53	$316.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.71 / $143.81 / $296.05	Professional		$92.71	$143.81	$296.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.26 / $46.42 / $71.29	Professional	26	$28.26	$46.42	$71.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.68 / $99.02 / $212.93	Professional	TC	$62.68	$99.02	$212.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.19 / $121.21 / $350.76	Professional		$110.19	$121.21	$350.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.66 / $28.23 / $118.74	Professional	26	$25.66	$28.23	$118.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $84.54 / $92.99 / $350.76	Professional	TC	$84.54	$92.99	$350.76
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,276.90 / $1,276.90 / $1,750.00	Facility		$1,276.90	$1,276.90	$1,750.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.13 / $120.19 / $231.20	Professional		$80.13	$120.19	$231.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.79 / $33.14 / $57.08	Professional	26	$22.79	$33.14	$57.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.68 / $87.01 / $173.49	Professional	TC	$51.68	$87.01	$173.49