Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $227.47 / $492.64 / $8,353.89	Facility	TC	$227.47	$492.64	$8,353.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.48 / $79.34 / $188.62	Professional		$48.48	$79.34	$188.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $26.54 / $109.65	Professional	26	$9.76	$26.54	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.66 / $64.98 / $171.98	Professional	TC	$45.66	$64.98	$171.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.94 / $39.72 / $96.30	Professional		$35.94	$39.72	$96.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.49 / $12.63 / $21.07	Professional	26	$5.49	$12.63	$21.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.17 / $112.03 / $126.42	Professional	TC	$30.17	$112.03	$126.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $57.67 / $168.03	Professional		$28.80	$57.67	$168.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $11.95 / $27.51	Professional	26	$5.04	$11.95	$27.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $42.76 / $126.45	Professional	TC	$23.76	$42.76	$126.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.37 / $84.48 / $146.96	Facility		$15.37	$84.48	$146.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.90 / $68.09 / $87.91	Professional		$10.90	$68.09	$87.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $41.37 / $216.08	Professional		$29.22	$41.37	$216.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $11.47 / $30.88	Professional	26	$5.80	$11.47	$30.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $35.53 / $185.20	Professional	TC	$26.10	$35.53	$185.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $99.86 / $636.04	Professional		$39.38	$99.86	$636.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $17.10 / $95.05	Professional	26	$10.22	$17.10	$95.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.28 / $102.58 / $541.00	Professional	TC	$61.28	$102.58	$541.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.92 / $75.70 / $134.30	Professional		$11.92	$75.70	$134.30
United Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $74.64 / $174.56	Professional		$44.31	$74.64	$174.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $12.62 / $26.09	Professional	26	$7.34	$12.62	$26.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.38 / $60.89 / $148.00	Professional	TC	$36.38	$60.89	$148.00