Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $50.12 / $83.18	Professional		$21.88	$50.12	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $15.49 / $45.71	Professional	26	$5.01	$15.49	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.12 / $58.88	Professional	TC	$15.85	$25.12	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $30.20 / $60.26	Professional		$14.45	$30.20	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $8.51 / $12.88	Professional	26	$3.16	$8.51	$12.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $45.71 / $81.28	Professional		$22.39	$45.71	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $9.12 / $17.38	Professional	26	$3.02	$9.12	$17.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $35.48 / $61.66	Professional	TC	$19.95	$35.48	$61.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $33.11 / $64.57	Facility		$9.12	$33.11	$64.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $28.18 / $40.74	Professional		$7.59	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $24.55 / $97.72	Professional		$15.14	$24.55	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $6.46 / $19.95	Professional	26	$3.24	$6.46	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $21.38 / $85.11	Professional	TC	$12.02	$21.38	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $50.12 / $251.19	Professional		$29.51	$50.12	$251.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.23 / $53.70	Professional	26	$6.17	$10.23	$53.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $39.81 / $194.98	Professional	TC	$23.44	$39.81	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $30.20 / $61.66	Professional		$7.24	$30.20	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $3.47 / $13.18 / $25.12	Facility		$3.47	$13.18	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $38.02 / $93.33	Professional		$18.62	$38.02	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $7.24 / $16.22	Professional	26	$4.27	$7.24	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $26.30 / $72.44	Professional	TC	$14.45	$26.30	$72.44