Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $149.47 / $333.90	Professional		$103.70	$149.47	$333.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $84.89 / $382.28	Professional	26	$51.94	$84.89	$382.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.69 / $72.20 / $151.18	Professional	TC	$56.69	$72.20	$151.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.27 / $77.76 / $308.47	Professional		$76.27	$77.76	$308.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.56 / $45.67 / $124.84	Professional	26	$31.56	$45.67	$124.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.22 / $145.66 / $351.46	Professional		$63.22	$145.66	$351.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.95 / $73.58 / $161.00	Professional	26	$29.95	$73.58	$161.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.26 / $47.52 / $163.19	Professional	TC	$33.26	$47.52	$163.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.63 / $129.66 / $241.90	Facility		$80.63	$129.66	$241.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.47 / $100.79 / $186.84	Professional		$63.47	$100.79	$186.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.31 / $117.17 / $451.93	Professional		$66.31	$117.17	$451.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.53 / $66.06 / $177.79	Professional	26	$33.53	$66.06	$177.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $49.85 / $274.14	Professional	TC	$28.92	$49.85	$274.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $149.54 / $250.32 / $1,220.39	Professional		$149.54	$250.32	$1,220.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $98.47 / $554.59	Professional	26	$58.82	$98.47	$554.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.71 / $151.85 / $665.80	Professional	TC	$90.71	$151.85	$665.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.63 / $144.91 / $282.02	Professional		$68.63	$144.91	$282.02
United Facility/Professional Professional Modifier Low / Median / High Price $92.02 / $155.88 / $341.22	Professional		$92.02	$155.88	$341.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.91 / $73.93 / $150.26	Professional	26	$42.91	$73.93	$150.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.83 / $78.18 / $199.38	Professional	TC	$45.83	$78.18	$199.38