Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $324.52 / $368.13 / $813.99	Facility	TC	$324.52	$368.13	$813.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $36.67 / $110.00	Professional		$27.44	$36.67	$110.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $13.76 / $65.58	Professional	26	$8.34	$13.76	$65.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $29.09 / $65.37	Professional	TC	$21.49	$29.09	$65.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.77 / $20.69 / $72.20	Professional		$18.77	$20.69	$72.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.17 / $13.44 / $19.75	Professional	26	$5.17	$13.44	$19.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.52 / $50.52 / $53.66	Professional	TC	$50.52	$50.52	$53.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.78 / $47.83 / $105.97	Professional		$24.78	$47.83	$105.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $11.80 / $27.20	Professional	26	$4.90	$11.80	$27.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $33.33 / $70.93	Professional	TC	$20.42	$33.33	$70.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.48 / $38.09 / $73.63	Facility		$14.48	$38.09	$73.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.26 / $30.68 / $46.12	Professional		$10.26	$30.68	$46.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.84 / $32.69 / $124.16	Professional		$20.84	$32.69	$124.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.29 / $10.79 / $33.19	Professional	26	$5.29	$10.79	$33.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.73 / $27.03 / $95.11	Professional	TC	$14.73	$27.03	$95.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $62.36 / $328.72	Professional		$37.25	$62.36	$328.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $16.14 / $89.58	Professional	26	$9.64	$16.14	$89.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $46.22 / $239.06	Professional	TC	$27.61	$46.22	$239.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $39.09 / $69.88	Professional		$11.89	$39.09	$69.88
United Facility/Professional Professional Modifier Low / Median / High Price $25.07 / $46.05 / $117.69	Professional		$25.07	$46.05	$117.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $11.90 / $25.01	Professional	26	$6.94	$11.90	$25.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.93 / $32.44 / $90.20	Professional	TC	$17.93	$32.44	$90.20