Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $190.55	Professional		$47.86	$64.57	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $51.29 / $158.49	Professional	26	$19.95	$51.29	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $134.90	Professional	TC	$26.92	$38.90	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $123.03	Professional		$30.20	$40.74	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $38.02 / $48.98	Professional	26	$12.59	$38.02	$48.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	TC	$17.78	$17.78	$17.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $72.44 / $186.21	Professional		$40.74	$72.44	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $28.18 / $91.20	Professional	26	$22.39	$28.18	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $35.48 / $87.10	Professional	TC	$18.62	$35.48	$87.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $56.23 / $125.89	Facility		$36.31	$56.23	$125.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $83.18	Professional		$30.20	$43.65	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.57 / $218.78	Professional		$33.88	$64.57	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $28.18 / $114.82	Professional	26	$13.49	$28.18	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.70 / $112.20	Professional	TC	$19.50	$25.70	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $524.81	Professional		$60.26	$100.00	$524.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $39.81 / $218.78	Professional	26	$23.44	$39.81	$218.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $60.26 / $309.03	Professional	TC	$36.31	$60.26	$309.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $61.66 / $123.03	Professional		$27.54	$61.66	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $54.95 / $125.89	Facility		$21.88	$54.95	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $81.28 / $190.55	Professional		$40.74	$81.28	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $33.88 / $85.11	Professional	26	$17.38	$33.88	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $107.15	Professional	TC	$23.99	$42.66	$107.15