Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $54.19 / $155.02	Professional		$40.49	$54.19	$155.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $49.99 / $187.40	Professional	26	$25.55	$49.99	$187.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $18.21 / $35.36	Professional	TC	$13.18	$18.21	$35.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.52 / $25.52 / $66.34	Professional		$25.52	$25.52	$66.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $23.24 / $61.33	Professional	26	$16.05	$23.24	$61.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $57.65 / $124.15	Professional		$23.62	$57.65	$124.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $36.00 / $81.75	Professional	26	$15.26	$36.00	$81.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.35 / $16.84 / $42.38	Professional	TC	$8.35	$16.84	$42.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.54 / $33.33 / $62.24	Professional		$19.54	$33.33	$62.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $52.75 / $148.66	Professional		$25.98	$52.75	$148.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.88 / $32.95 / $90.65	Professional	26	$14.88	$32.95	$90.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.57 / $11.37 / $58.44	Professional	TC	$9.57	$11.37	$58.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $82.34 / $435.02	Professional		$49.19	$82.34	$435.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.00 / $50.21 / $280.22	Professional	26	$30.00	$50.21	$280.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $32.14 / $154.79	Professional	TC	$19.20	$32.14	$154.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.40 / $48.49 / $93.49	Professional		$22.40	$48.49	$93.49
United Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $56.96 / $125.64	Professional		$32.63	$56.96	$125.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $37.51 / $76.04	Professional	26	$21.70	$37.51	$76.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.51 / $19.73 / $47.96	Professional	TC	$11.51	$19.73	$47.96