Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $78.65 / $237.77	Facility	26	$55.00	$78.65	$237.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $275.00 / $585.86	Professional		$171.00	$275.00	$585.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.30 / $81.64 / $165.20	Professional	26	$53.30	$81.64	$165.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $220.00 / $444.03	Professional	TC	$119.70	$220.00	$444.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.33 / $115.33 / $217.09	Professional		$115.33	$115.33	$217.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $67.61 / $95.65	Professional	26	$39.65	$67.61	$95.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $170.15 / $170.15 / $170.15	Professional	TC	$170.15	$170.15	$170.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.16 / $268.17 / $508.08	Professional		$150.16	$268.17	$508.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.91 / $75.48 / $150.77	Professional	26	$50.91	$75.48	$150.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.26 / $171.18 / $360.08	Professional	TC	$99.26	$171.18	$360.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $116.26 / $197.25	Professional		$54.52	$116.26	$197.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.99 / $348.37 / $608.92	Professional		$164.99	$348.37	$608.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $94.18 / $160.80	Professional	26	$54.56	$94.18	$160.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.66 / $236.91 / $476.07	Professional	TC	$110.66	$236.91	$476.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.69 / $299.44 / $888.13	Professional		$164.69	$299.44	$888.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.76 / $93.81 / $198.01	Professional	26	$56.76	$93.81	$198.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.93 / $196.24 / $761.79	Professional	TC	$107.93	$196.24	$761.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $148.52 / $269.50	Professional		$74.56	$148.52	$269.50
United Facility/Professional Professional Modifier Low / Median / High Price $163.78 / $267.83 / $512.39	Professional		$163.78	$267.83	$512.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.70 / $78.76 / $127.37	Professional	26	$54.70	$78.76	$127.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.20 / $190.19 / $354.21	Professional	TC	$103.20	$190.19	$354.21