Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $114.17 / $210.00	Professional		$70.00	$114.17	$210.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $35.94 / $143.15	Professional	26	$24.10	$35.94	$143.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.85 / $83.70 / $403.26	Professional	TC	$48.85	$83.70	$403.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.06 / $171.06 / $171.06	Professional		$171.06	$171.06	$171.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.29 / $16.29 / $58.24	Professional	26	$16.29	$16.29	$58.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $86.30 / $282.45	Professional		$41.39	$86.30	$282.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $37.57 / $85.51	Professional	26	$16.48	$37.57	$85.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $41.80 / $178.03	Professional	TC	$24.92	$41.80	$178.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $106.19 / $155.81	Professional		$32.74	$106.19	$155.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.96 / $76.63 / $303.58	Professional		$45.96	$76.63	$303.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $34.26 / $92.21	Professional	26	$18.30	$34.26	$92.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $57.46 / $288.82	Professional	TC	$24.98	$57.46	$288.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.86 / $210.68 / $1,136.75	Professional		$125.86	$210.68	$1,136.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.29 / $50.70 / $283.02	Professional	26	$30.29	$50.70	$283.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $95.57 / $159.99 / $853.71	Professional	TC	$95.57	$159.99	$853.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $131.38 / $234.51	Professional		$37.47	$131.38	$234.51
United Facility/Professional Professional Modifier Low / Median / High Price $68.33 / $110.35 / $299.10	Professional		$68.33	$110.35	$299.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.51 / $38.06 / $80.83	Professional	26	$22.51	$38.06	$80.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.43 / $76.45 / $244.13	Professional	TC	$49.43	$76.45	$244.13