Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $39.81 / $93.33	Facility	26	$17.38	$39.81	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $245.47	Professional		$70.79	$112.20	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $93.33	Professional	26	$16.98	$23.44	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $70.79 / $154.88	Professional	TC	$51.29	$70.79	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $165.96	Professional		$128.82	$134.90	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $31.62 / $38.02	Professional	26	$18.62	$31.62	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $165.96	Professional		$74.13	$104.71	$165.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.12 / $38.90	Professional	26	$19.95	$25.12	$38.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $77.62 / $131.83	Professional	TC	$54.95	$77.62	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $229.09	Professional		$77.62	$123.03	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $29.51 / $52.48	Professional	26	$17.38	$29.51	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $93.33 / $186.21	Professional	TC	$60.26	$93.33	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $446.68	Professional		$100.00	$128.82	$446.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.70 / $114.82	Professional	26	$19.95	$25.70	$114.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $104.71 / $331.13	Professional	TC	$79.43	$104.71	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $91.20 / $162.18	Professional		$20.89	$91.20	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $190.55	Professional		$79.43	$102.33	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $24.55 / $43.65	Professional	26	$19.05	$24.55	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $79.43 / $147.91	Professional	TC	$58.88	$79.43	$147.91