Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $68.75 / $210.99	Facility	26	$55.00	$68.75	$210.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.38 / $275.00 / $636.38	Professional		$159.38	$275.00	$636.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $55.00 / $180.98	Professional	26	$44.14	$55.00	$180.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.84 / $220.00 / $425.97	Professional	TC	$110.84	$220.00	$425.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.56 / $152.46 / $237.68	Professional		$98.56	$152.46	$237.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $66.12 / $86.75	Professional	26	$34.99	$66.12	$86.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.01 / $123.01 / $123.01	Professional	TC	$123.01	$123.01	$123.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.21 / $242.41 / $457.94	Professional		$130.21	$242.41	$457.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.42 / $71.13 / $130.22	Professional	26	$45.42	$71.13	$130.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.12 / $158.07 / $335.79	Professional	TC	$85.12	$158.07	$335.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $102.28 / $165.84	Professional		$48.08	$102.28	$165.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.13 / $323.97 / $570.70	Professional		$169.13	$323.97	$570.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $83.58 / $152.79	Professional	26	$50.44	$83.58	$152.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.09 / $227.68 / $428.23	Professional	TC	$119.09	$227.68	$428.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $256.04 / $765.74	Professional		$140.82	$256.04	$765.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.96 / $83.51 / $233.91	Professional	26	$49.96	$83.51	$233.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.86 / $165.20 / $765.74	Professional	TC	$90.86	$165.20	$765.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.40 / $122.99 / $235.85	Professional		$65.40	$122.99	$235.85
United Facility/Professional Professional Modifier Low / Median / High Price $150.46 / $268.72 / $484.34	Professional		$150.46	$268.72	$484.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.46 / $69.17 / $112.33	Professional	26	$48.46	$69.17	$112.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.79 / $185.60 / $310.08	Professional	TC	$97.79	$185.60	$310.08