Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $29.51 / $36.31	Professional	26	$23.44	$29.51	$36.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $66.07 / $158.49	Professional		$26.92	$66.07	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $269.15 / $275.42	Professional		$89.13	$269.15	$275.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $74.13	Professional	26	$35.48	$35.48	$74.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $93.33 / $199.53	Professional	TC	$93.33	$93.33	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $70.79 / $100.00	Professional		$23.99	$70.79	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $208.93	Professional		$75.86	$123.03	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.99 / $50.12	Professional	26	$17.78	$23.99	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $91.20 / $151.36	Professional	TC	$54.95	$91.20	$151.36