Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.47 / $55.71 / $124.80	Facility	26	$24.47	$55.71	$124.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $115.12 / $236.67	Professional		$90.73	$115.12	$236.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $25.85 / $62.75	Professional	26	$22.74	$25.85	$62.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.56 / $86.71 / $183.83	Professional	TC	$70.56	$86.71	$183.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.26 / $43.41 / $51.55	Professional	26	$23.26	$43.41	$51.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.86 / $144.38 / $301.43	Professional		$93.86	$144.38	$301.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.08 / $37.28 / $74.97	Professional	26	$25.08	$37.28	$74.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.27 / $112.81 / $235.53	Professional	TC	$69.27	$112.81	$235.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.85 / $162.94 / $318.54	Professional		$95.85	$162.94	$318.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.13 / $44.41 / $75.16	Professional	26	$26.13	$44.41	$75.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.66 / $119.28 / $235.90	Professional	TC	$73.66	$119.28	$235.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.97 / $211.98 / $444.45	Professional		$132.97	$211.98	$444.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.69 / $47.33 / $100.81	Professional	26	$29.69	$47.33	$100.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $103.28 / $164.65 / $345.22	Professional	TC	$103.28	$164.65	$345.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $131.44 / $223.29	Professional		$38.79	$131.44	$223.29
United Facility/Professional Professional Modifier Low / Median / High Price $103.11 / $144.35 / $274.23	Professional		$103.11	$144.35	$274.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.15 / $36.35 / $64.73	Professional	26	$25.15	$36.35	$64.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.92 / $104.20 / $201.89	Professional	TC	$75.92	$104.20	$201.89