Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.59 / $742.50 / $1,649.07	Facility		$224.59	$742.50	$1,649.07
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.76 / $46.36 / $133.83	Facility	26	$34.76	$46.36	$133.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $201.11 / $312.85 / $774.27	Facility	TC	$201.11	$312.85	$774.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.83 / $271.22 / $581.04	Professional		$199.83	$271.22	$581.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $40.86 / $90.18	Professional	26	$29.65	$40.86	$90.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.58 / $221.22 / $440.08	Professional	TC	$178.58	$221.22	$440.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.12 / $309.05 / $424.85	Professional		$175.12	$309.05	$424.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $52.60 / $66.70	Professional	26	$27.64	$52.60	$66.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $231.00 / $308.93 / $317.68	Professional	TC	$231.00	$308.93	$317.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.19 / $637.66 / $753.01	Facility		$323.19	$637.66	$753.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $317.38 / $611.64	Professional		$195.00	$317.38	$611.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.34 / $42.51 / $94.47	Professional	26	$29.34	$42.51	$94.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.69 / $269.07 / $514.22	Professional	TC	$163.69	$269.07	$514.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.57 / $239.55 / $320.36	Facility		$45.57	$239.55	$320.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.38 / $195.56 / $317.64	Professional		$37.38	$195.56	$317.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.00 / $438.16 / $565.79	Facility		$268.00	$438.16	$565.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $69.31	Facility	26	$42.91	$42.91	$69.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $227.42	Facility	TC	$227.42	$227.42	$227.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $347.77 / $645.17	Professional		$228.90	$347.77	$645.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $50.64 / $83.23	Professional	26	$32.11	$50.64	$83.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.80 / $308.50 / $553.28	Professional	TC	$197.80	$308.50	$553.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.71 / $343.25 / $752.57	Professional		$251.71	$343.25	$752.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.39 / $50.13 / $109.25	Professional	26	$39.39	$50.13	$109.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $212.32 / $289.52 / $645.04	Professional	TC	$212.32	$289.52	$645.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $525.69 / $594.13 / $710.22	Facility		$525.69	$594.13	$710.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.03 / $237.08 / $400.89	Professional		$43.03	$237.08	$400.89
United Facility/Professional Professional Modifier Low / Median / High Price $249.91 / $361.62 / $573.65	Professional		$249.91	$361.62	$573.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $48.29 / $79.73	Professional	26	$34.03	$48.29	$79.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.89 / $305.58 / $526.23	Professional	TC	$213.89	$305.58	$526.23