Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $66.20 / $149.60	Professional		$42.36	$66.20	$149.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $25.28 / $143.52	Professional	26	$16.47	$25.28	$143.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.77 / $40.83 / $73.73	Professional	TC	$25.77	$40.83	$73.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $20.39 / $40.21	Professional	26	$10.15	$20.39	$40.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $58.77 / $137.44	Professional		$28.32	$58.77	$137.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $22.92 / $53.48	Professional	26	$9.50	$22.92	$53.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $25.48 / $78.72	Professional	TC	$19.73	$25.48	$78.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.43 / $58.09 / $112.32	Facility		$28.43	$58.09	$112.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $46.80 / $75.88	Professional		$20.35	$46.80	$75.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $47.88 / $184.56	Professional		$31.79	$47.88	$184.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $21.32 / $63.14	Professional	26	$11.01	$21.32	$63.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.45 / $25.04 / $127.31	Professional	TC	$19.45	$25.04	$127.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.07 / $102.22 / $497.42	Professional		$61.07	$102.22	$497.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.95 / $31.71 / $176.74	Professional	26	$18.95	$31.71	$176.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.12 / $70.51 / $320.68	Professional	TC	$42.12	$70.51	$320.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.10 / $63.83 / $115.22	Professional		$22.10	$63.83	$115.22
United Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $63.58 / $155.99	Professional		$37.45	$63.58	$155.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $23.70 / $52.37	Professional	26	$13.93	$23.70	$52.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.77 / $39.70 / $107.17	Professional	TC	$23.77	$39.70	$107.17