Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $475.51 / $498.09 / $996.17	Facility	TC	$475.51	$498.09	$996.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.03 / $90.92 / $234.21	Professional		$64.03	$90.92	$234.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $49.00 / $237.12	Professional	26	$26.61	$49.00	$237.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.09 / $62.69 / $172.18	Professional	TC	$44.09	$62.69	$172.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.53 / $54.42 / $183.92	Professional		$49.53	$54.42	$183.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $36.54 / $60.32	Professional	26	$15.88	$36.54	$60.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.74 / $38.08 / $125.28	Professional	TC	$33.74	$38.08	$125.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $93.00 / $234.97	Professional		$44.64	$93.00	$234.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $37.35 / $83.04	Professional	26	$16.34	$37.35	$83.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.66 / $43.35 / $137.77	Professional	TC	$29.66	$43.35	$137.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.21 / $94.47 / $182.76	Facility		$44.21	$94.47	$182.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $76.15 / $121.68	Professional		$31.75	$76.15	$121.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $75.59 / $296.02	Professional		$48.52	$75.59	$296.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $40.40 / $89.55	Professional	26	$18.01	$40.40	$89.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $40.21 / $208.65	Professional	TC	$26.10	$40.21	$208.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $138.68 / $826.69	Professional		$71.81	$138.68	$826.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.41 / $49.24 / $274.83	Professional	26	$29.41	$49.24	$274.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $68.54 / $114.73 / $551.85	Professional	TC	$68.54	$114.73	$551.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $102.49 / $182.94	Professional		$36.32	$102.49	$182.94
United Facility/Professional Professional Modifier Low / Median / High Price $61.85 / $107.02 / $250.20	Professional		$61.85	$107.02	$250.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.07 / $37.35 / $86.81	Professional	26	$22.07	$37.35	$86.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.65 / $70.23 / $171.30	Professional	TC	$38.65	$70.23	$171.30