Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $151.36	Professional		$39.81	$52.48	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $67.61 / $190.55	Professional	26	$25.70	$67.61	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $18.20 / $41.69	Professional	TC	$14.13	$18.20	$41.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Professional		$25.70	$25.70	$25.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $57.54 / $61.66	Professional	26	$21.88	$57.54	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $64.57 / $114.82	Professional		$23.44	$64.57	$114.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $38.02 / $75.86	Professional	26	$15.14	$38.02	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $21.38 / $46.77	Professional	TC	$8.32	$21.38	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.90 / $70.79	Professional		$23.44	$38.90	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $50.12 / $147.91	Professional		$26.30	$50.12	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $28.84 / $91.20	Professional	26	$14.79	$28.84	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $11.22 / $58.88	Professional	TC	$9.33	$11.22	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $83.18 / $436.52	Professional		$48.98	$83.18	$436.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $50.12 / $281.84	Professional	26	$30.20	$50.12	$281.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $32.36 / $154.88	Professional	TC	$19.50	$32.36	$154.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $51.29 / $100.00	Professional		$21.38	$51.29	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $131.83	Professional		$33.11	$57.54	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $37.15 / $79.43	Professional	26	$21.88	$37.15	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $19.95 / $48.98	Professional	TC	$11.48	$19.95	$48.98