Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $309.03	Professional		$81.28	$117.49	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $109.65 / $512.86	Professional	26	$34.67	$109.65	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $74.13 / $169.82	Professional	TC	$50.12	$74.13	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $208.93	Professional		$54.95	$57.54	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $43.65 / $72.44	Professional	26	$19.05	$43.65	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $251.19	Professional		$54.95	$109.65	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $53.70 / $107.15	Professional	26	$20.42	$53.70	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $56.23 / $138.04	Professional	TC	$35.48	$56.23	$138.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $97.72 / $218.78	Facility		$53.70	$97.72	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $83.18 / $144.54	Professional		$45.71	$83.18	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $346.74	Professional		$56.23	$112.20	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $38.90 / $117.49	Professional	26	$20.42	$38.90	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $45.71 / $208.93	Professional	TC	$29.51	$45.71	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $977.24	Professional		$109.65	$181.97	$977.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $58.88 / $331.13	Professional	26	$35.48	$58.88	$331.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $123.03 / $645.65	Professional	TC	$74.13	$123.03	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $112.20 / $223.87	Professional		$41.69	$112.20	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $61.66 / $114.82	Facility		$45.71	$61.66	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $288.40	Professional		$72.44	$125.89	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $53.70 / $107.15	Professional	26	$26.30	$53.70	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $75.86 / $177.83	Professional	TC	$47.86	$75.86	$177.83