Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.05 / $699.66 / $1,645.20	Facility		$186.05	$699.66	$1,645.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.62 / $36.02 / $117.93	Facility	26	$30.62	$36.02	$117.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $151.10 / $457.46 / $1,023.81	Facility	TC	$151.10	$457.46	$1,023.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.18 / $244.00 / $510.27	Professional		$176.18	$244.00	$510.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.46 / $38.65 / $128.00	Professional	26	$30.46	$38.65	$128.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.19 / $168.21 / $357.19	Professional	TC	$148.19	$168.21	$357.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.04 / $217.65 / $331.87	Professional		$137.04	$217.65	$331.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.89 / $49.58 / $59.67	Professional	26	$25.89	$49.58	$59.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $176.53 / $176.53 / $234.98	Professional	TC	$176.53	$176.53	$234.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.95 / $488.20 / $576.51	Facility		$235.95	$488.20	$576.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.84 / $255.83 / $515.85	Professional		$161.84	$255.83	$515.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.61 / $43.19 / $81.73	Professional	26	$28.61	$43.19	$81.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.75 / $207.42 / $391.14	Professional	TC	$132.75	$207.42	$391.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.75 / $183.06 / $250.25	Facility		$39.75	$183.06	$250.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $149.46 / $248.34	Professional		$32.19	$149.46	$248.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.36 / $339.52 / $430.35	Facility		$215.36	$339.52	$430.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.51 / $37.51 / $60.63	Facility	26	$37.51	$37.51	$60.63
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $172.98 / $172.98 / $172.98	Facility	TC	$172.98	$172.98	$172.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.64 / $279.83 / $502.98	Professional		$184.64	$279.83	$502.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.63 / $47.33 / $87.49	Professional	26	$33.63	$47.33	$87.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.58 / $241.36 / $432.20	Professional	TC	$154.58	$241.36	$432.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $196.63 / $268.13 / $585.10	Professional		$196.63	$268.13	$585.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $46.86 / $260.14	Professional	26	$34.36	$46.86	$260.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.26 / $221.27 / $504.67	Professional	TC	$162.26	$221.27	$504.67
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,602.83 / $1,797.73 / $2,164.00	Facility		$1,602.83	$1,797.73	$2,164.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.01 / $169.81 / $295.58	Professional		$33.01	$169.81	$295.58
United Facility/Professional Professional Modifier Low / Median / High Price $197.86 / $279.83 / $484.75	Professional		$197.86	$279.83	$484.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $46.75 / $78.06	Professional	26	$34.46	$46.75	$78.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.91 / $230.87 / $391.39	Professional	TC	$159.91	$230.87	$391.39