Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $175.87 / $758.92 / $3,735.31	Facility	TC	$175.87	$758.92	$3,735.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.72 / $20.57 / $39.13	Professional		$13.72	$20.57	$39.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $15.24 / $75.62	Professional	26	$8.99	$15.24	$75.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.77 / $7.40 / $18.66	Professional	TC	$5.77	$7.40	$18.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.24 / $9.34 / $9.89	Professional		$9.24	$9.34	$9.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $14.65 / $21.53	Professional	26	$5.63	$14.65	$21.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.07 / $18.14 / $47.92	Professional		$9.07	$18.14	$47.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.33 / $12.33 / $28.30	Professional	26	$5.33	$12.33	$28.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.74 / $5.00 / $17.66	Professional	TC	$3.74	$5.00	$17.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.72 / $15.82 / $36.36	Facility		$9.72	$15.82	$36.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.31 / $11.68 / $22.50	Professional		$7.31	$11.68	$22.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.99 / $19.05 / $53.80	Professional		$8.99	$19.05	$53.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.84 / $11.77 / $31.76	Professional	26	$5.84	$11.77	$31.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.76 / $5.91 / $22.21	Professional	TC	$2.76	$5.91	$22.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $29.80 / $165.49	Professional		$17.80	$29.80	$165.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $17.60 / $97.78	Professional	26	$10.51	$17.60	$97.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $7.29 / $12.20 / $67.70	Professional	TC	$7.29	$12.20	$67.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.82 / $17.98 / $34.42	Professional		$8.82	$17.98	$34.42
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $21.99 / $47.28	Professional		$12.59	$21.99	$47.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $12.99 / $28.06	Professional	26	$7.56	$12.99	$28.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.84 / $9.01 / $19.46	Professional	TC	$4.84	$9.01	$19.46