Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.09 / $120.00 / $326.77	Facility		$36.09	$120.00	$326.77
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.32 / $22.03 / $38.00	Facility	26	$19.32	$22.03	$38.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.77 / $219.28 / $326.77	Facility	TC	$16.77	$219.28	$326.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.93 / $70.00 / $124.54	Professional		$35.93	$70.00	$124.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $24.23 / $52.93	Professional	26	$19.32	$24.23	$52.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.72 / $94.72 / $234.74	Professional	50	$94.72	$94.72	$234.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.25 / $19.05 / $57.10	Professional	52	$16.25	$19.05	$57.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $30.45 / $85.03	Professional	TC	$15.65	$30.45	$85.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.38 / $63.20 / $80.05	Professional		$37.38	$63.20	$80.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $36.31	Professional	26	$36.31	$36.31	$36.31
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.58 / $8.58 / $8.58	Professional	52	$8.58	$8.58	$8.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $64.45 / $121.11	Professional		$33.93	$64.45	$121.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $24.88 / $46.38	Professional	26	$18.32	$24.88	$46.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.90 / $96.76 / $181.66	Professional	50	$50.90	$96.76	$181.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.04 / $36.63 / $78.84	Professional	TC	$16.04	$36.63	$78.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.82 / $27.42 / $50.30	Facility		$18.82	$27.42	$50.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $26.66 / $46.28	Professional		$15.84	$26.66	$46.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $41.38 / $41.38	Facility		$41.38	$41.38	$41.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $18.64	Facility	TC	$18.64	$18.64	$18.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $75.47 / $132.79	Professional		$40.36	$75.47	$132.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.45 / $30.53 / $51.80	Professional	26	$19.45	$30.53	$51.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $45.16 / $85.23	Professional	TC	$19.80	$45.16	$85.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $71.20 / $229.71	Professional		$39.15	$71.20	$229.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.73 / $39.50 / $76.39	Professional	26	$21.73	$39.50	$76.39
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $25.74 / $25.74 / $34.32	Professional	52	$25.74	$25.74	$34.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.42 / $31.68 / $147.61	Professional	TC	$17.42	$31.68	$147.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $222.98 / $224.96 / $267.85	Facility		$222.98	$224.96	$267.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.70 / $32.20 / $63.30	Professional		$19.70	$32.20	$63.30
United Facility/Professional Professional Modifier Low / Median / High Price $43.23 / $73.23 / $117.04	Professional		$43.23	$73.23	$117.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.63 / $28.60 / $47.67	Professional	26	$20.63	$28.60	$47.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.39 / $38.03 / $76.68	Professional	TC	$21.39	$38.03	$76.68