Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.91 / $15.41 / $77.25	Facility	26	$14.91	$15.41	$77.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $71.55 / $196.00	Professional		$61.64	$71.55	$196.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $16.30 / $40.17	Professional	26	$13.87	$16.30	$40.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.63 / $136.06	Professional	TC	$44.67	$52.63	$136.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $70.00 / $130.72	Professional		$59.33	$70.00	$130.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.25 / $21.56 / $28.09	Professional	26	$14.25	$21.56	$28.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $88.71 / $186.58	Professional		$63.60	$88.71	$186.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.11 / $22.46 / $40.28	Professional	26	$16.11	$22.46	$40.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.07 / $69.64 / $146.10	Professional	TC	$46.07	$69.64	$146.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $109.25 / $200.12	Professional		$68.59	$109.25	$200.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.52 / $26.91 / $46.20	Professional	26	$17.52	$26.91	$46.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $82.94 / $151.15	Professional	TC	$50.89	$82.94	$151.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.32 / $136.01 / $693.00	Professional		$85.32	$136.01	$693.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.17 / $28.97 / $180.18	Professional	26	$18.17	$28.97	$180.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.14 / $107.04 / $512.82	Professional	TC	$67.14	$107.04	$512.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.46 / $81.39 / $133.02	Professional		$22.46	$81.39	$133.02
United Facility/Professional Professional Modifier Low / Median / High Price $68.61 / $87.74 / $162.74	Professional		$68.61	$87.74	$162.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $22.46 / $40.08	Professional	26	$16.57	$22.46	$40.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.63 / $70.42 / $129.72	Professional	TC	$50.63	$70.42	$129.72