Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $190.55 / $758.58 / $3,715.35	Facility	TC	$190.55	$758.58	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $19.50 / $47.86	Professional		$13.80	$19.50	$47.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $26.30 / $79.43	Professional	26	$9.12	$26.30	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.25 / $7.76 / $21.38	Professional	TC	$5.25	$7.76	$21.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $10.00 / $18.62	Professional		$9.33	$10.00	$18.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $14.79 / $22.39	Professional	26	$5.62	$14.79	$22.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $14.45 / $14.45	Professional	TC	$14.45	$14.45	$14.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $21.38 / $42.66	Professional		$9.12	$21.38	$42.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $15.49 / $26.30	Professional	26	$5.37	$15.49	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $6.31 / $13.80	Professional	TC	$3.72	$6.31	$13.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $16.98 / $38.02	Facility		$10.47	$16.98	$38.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $13.49 / $25.12	Professional		$8.91	$13.49	$25.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $18.62 / $53.70	Professional		$8.91	$18.62	$53.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $11.48 / $31.62	Professional	26	$5.89	$11.48	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.75 / $4.68 / $22.39	Professional	TC	$2.75	$4.68	$22.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.20 / $165.96	Professional		$18.20	$30.20	$165.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.38 / $97.72	Professional	26	$10.23	$17.38	$97.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $7.76 / $12.88 / $67.61	Professional	TC	$7.76	$12.88	$67.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $19.50 / $38.02	Professional		$8.91	$19.50	$38.02
United Facility/Professional Facility Modifier Low / Median / High Price $2.95 / $10.47 / $18.20	Facility		$2.95	$10.47	$18.20
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $21.88 / $47.86	Professional		$12.59	$21.88	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.88 / $30.20	Professional	26	$7.59	$12.88	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $8.13 / $18.20	Professional	TC	$5.01	$8.13	$18.20