Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $60.89 / $140.96	Professional		$50.53	$60.89	$140.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $27.62 / $130.32	Professional	26	$5.83	$27.62	$130.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.38 / $38.08 / $90.14	Professional	TC	$26.38	$38.08	$90.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.13 / $30.13 / $114.11	Professional		$30.13	$30.13	$114.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $35.81 / $47.85	Professional	26	$12.52	$35.81	$47.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.98 / $57.40 / $180.54	Professional		$40.98	$57.40	$180.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $22.46 / $84.93	Professional	26	$22.46	$22.46	$84.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.52 / $18.52 / $86.35	Professional	TC	$18.52	$18.52	$86.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.77 / $51.05 / $95.30	Facility		$31.77	$51.05	$95.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.13 / $39.71 / $73.81	Professional		$25.13	$39.71	$73.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.68 / $63.77 / $216.81	Professional		$33.68	$63.77	$216.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $28.51 / $101.80	Professional	26	$13.55	$28.51	$101.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $26.81 / $111.47	Professional	TC	$19.64	$26.81	$111.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.05 / $98.85 / $527.41	Professional		$59.05	$98.85	$527.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.31 / $39.02 / $217.59	Professional	26	$23.31	$39.02	$217.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.74 / $59.83 / $309.82	Professional	TC	$35.74	$59.83	$309.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.20 / $57.25 / $111.44	Professional		$27.20	$57.25	$111.44
United Facility/Professional Professional Modifier Low / Median / High Price $41.08 / $80.23 / $191.85	Professional		$41.08	$80.23	$191.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $33.54 / $78.88	Professional	26	$17.30	$33.54	$78.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.77 / $39.89 / $94.96	Professional	TC	$23.77	$39.89	$94.96