Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.90 / $85.03 / $197.85	Professional		$63.90	$85.03	$197.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.46 / $63.01 / $192.02	Professional	26	$41.46	$63.01	$192.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $28.54 / $60.85	Professional	TC	$22.44	$28.54	$60.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.38 / $41.38 / $41.38	Professional		$41.38	$41.38	$41.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $30.99 / $106.62	Professional	26	$27.91	$30.99	$106.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $78.00 / $189.97	Professional		$38.79	$78.00	$189.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $60.33 / $141.12	Professional	26	$26.64	$60.33	$141.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $24.42 / $58.10	Professional	TC	$14.84	$24.42	$58.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $57.93 / $100.82	Professional		$27.89	$57.93	$100.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $86.77 / $264.85	Professional		$43.22	$86.77	$264.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.08 / $57.45 / $158.72	Professional	26	$29.08	$57.45	$158.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.77 / $18.82 / $84.40	Professional	TC	$12.77	$18.82	$84.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $133.00 / $750.54	Professional		$79.45	$133.00	$750.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.14 / $87.28 / $486.95	Professional	26	$52.14	$87.28	$486.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.32 / $45.74 / $263.58	Professional	TC	$27.32	$45.74	$263.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $83.49 / $152.35	Professional		$32.03	$83.49	$152.35
United Facility/Professional Professional Modifier Low / Median / High Price $54.73 / $92.03 / $212.07	Professional		$54.73	$92.03	$212.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.84 / $65.28 / $133.19	Professional	26	$37.84	$65.28	$133.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.99 / $26.71 / $68.11	Professional	TC	$15.99	$26.71	$68.11