Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.47 / $36.04 / $80.00	Professional		$21.47	$36.04	$80.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.30 / $10.11 / $45.69	Professional	26	$5.30	$10.11	$45.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $22.31 / $55.41	Professional	TC	$16.64	$22.31	$55.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.61 / $14.61 / $37.97	Professional		$14.61	$14.61	$37.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.12 / $8.16 / $12.42	Professional	26	$3.12	$8.16	$12.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.70 / $11.70 / $11.70	Professional	TC	$11.70	$11.70	$11.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $35.63 / $82.19	Professional		$22.33	$35.63	$82.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $7.22 / $16.53	Professional	26	$3.02	$7.22	$16.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $26.33 / $61.19	Professional	TC	$19.73	$26.33	$61.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.78 / $32.10 / $59.85	Facility		$8.78	$32.10	$59.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.15 / $25.84 / $35.90	Professional		$6.15	$25.84	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.25 / $25.88 / $97.71	Professional		$15.25	$25.88	$97.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.25 / $6.51 / $20.17	Professional	26	$3.25	$6.51	$20.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.87 / $22.60 / $80.11	Professional	TC	$11.87	$22.60	$80.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.12 / $48.74 / $249.76	Professional		$29.12	$48.74	$249.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $5.85 / $9.78 / $54.20	Professional	26	$5.85	$9.78	$54.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $38.93 / $195.56	Professional	TC	$23.26	$38.93	$195.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.15 / $30.67 / $54.62	Professional		$7.15	$30.67	$54.62
United Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $34.54 / $92.70	Professional		$18.80	$34.54	$92.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.23 / $7.22 / $15.99	Professional	26	$4.23	$7.22	$15.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.47 / $26.23 / $68.41	Professional	TC	$14.47	$26.23	$68.41