Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $107.82 / $276.30	Professional		$75.95	$107.82	$276.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $63.18 / $330.69	Professional	26	$31.83	$63.18	$330.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.21 / $69.70 / $120.54	Professional	TC	$50.21	$69.70	$120.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.67 / $52.67 / $195.57	Professional		$52.67	$52.67	$195.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.79 / $38.97 / $71.76	Professional	26	$18.79	$38.97	$71.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $77.48 / $251.65	Professional		$54.58	$77.48	$251.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $36.75 / $98.65	Professional	26	$20.42	$36.75	$98.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $42.77 / $161.71	Professional	TC	$35.86	$42.77	$161.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.60 / $94.88 / $183.53	Facility		$52.60	$94.88	$183.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $76.47 / $129.28	Professional		$37.79	$76.47	$129.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $112.71 / $345.89	Professional		$55.53	$112.71	$345.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.49 / $38.89 / $116.47	Professional	26	$20.49	$38.89	$116.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.29 / $45.45 / $209.54	Professional	TC	$29.29	$45.45	$209.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.77 / $173.71 / $973.59	Professional		$103.77	$173.71	$973.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.94 / $58.49 / $329.27	Professional	26	$34.94	$58.49	$329.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $115.21 / $644.33	Professional	TC	$68.81	$115.21	$644.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.21 / $108.04 / $199.97	Professional		$43.21	$108.04	$199.97
United Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $127.20 / $276.97	Professional		$72.09	$127.20	$276.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.40 / $53.91 / $102.43	Professional	26	$26.40	$53.91	$102.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.42 / $83.20 / $173.47	Professional	TC	$47.42	$83.20	$173.47