Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $47.59 / $115.90	Facility	26	$23.32	$47.59	$115.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.19 / $114.38 / $271.08	Professional		$97.19	$114.38	$271.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.74 / $25.14 / $75.43	Professional	26	$21.74	$25.14	$75.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $88.90 / $208.67	Professional	TC	$73.93	$88.90	$208.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.11 / $164.11 / $164.11	Professional		$164.11	$164.11	$164.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.49 / $23.49 / $49.62	Professional	26	$23.49	$23.49	$49.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.70 / $147.26 / $307.44	Professional		$98.70	$147.26	$307.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.68 / $35.68 / $73.76	Professional	26	$24.68	$35.68	$73.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.23 / $117.64 / $245.63	Professional	TC	$72.23	$117.64	$245.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.17 / $169.29 / $312.36	Professional		$99.17	$169.29	$312.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.31 / $42.19 / $71.29	Professional	26	$25.31	$42.19	$71.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.58 / $126.94 / $243.46	Professional	TC	$76.58	$126.94	$243.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.88 / $219.81 / $460.91	Professional		$137.88	$219.81	$460.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $45.56 / $95.94	Professional	26	$28.58	$45.56	$95.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.31 / $174.26 / $365.36	Professional	TC	$109.31	$174.26	$365.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $137.04 / $230.98	Professional		$36.61	$137.04	$230.98
United Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $146.57 / $273.62	Professional		$102.26	$146.57	$273.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $34.46 / $60.25	Professional	26	$24.51	$34.46	$60.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.75 / $104.99 / $206.21	Professional	TC	$77.75	$104.99	$206.21