Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.08 / $33.96 / $126.32	Facility	26	$25.08	$33.96	$126.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $95.15 / $258.01	Professional		$81.44	$95.15	$258.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $35.40 / $91.68	Professional	26	$21.12	$35.40	$91.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.84 / $69.73 / $167.15	Professional	TC	$52.84	$69.73	$167.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $75.72 / $83.10	Professional		$71.53	$75.72	$83.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.36 / $40.17 / $51.24	Professional	26	$21.36	$40.17	$51.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $109.15 / $227.43	Professional		$77.48	$109.15	$227.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.57 / $34.02 / $71.09	Professional	26	$23.57	$34.02	$71.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.96 / $77.45 / $161.71	Professional	TC	$50.96	$77.45	$161.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $72.00 / $131.58	Professional		$29.08	$72.00	$131.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $132.38 / $246.27	Professional		$76.95	$132.38	$246.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.56 / $40.35 / $75.50	Professional	26	$23.56	$40.35	$75.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.00 / $95.54 / $176.24	Professional	TC	$53.00	$95.54	$176.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.42 / $163.28 / $342.36	Professional		$102.42	$163.28	$342.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.36 / $48.40 / $101.48	Professional	26	$30.36	$48.40	$101.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.06 / $114.88 / $240.88	Professional	TC	$72.06	$114.88	$240.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $96.42 / $173.73	Professional		$39.88	$96.42	$173.73
United Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $109.84 / $202.40	Professional		$79.77	$109.84	$202.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.71 / $33.72 / $61.36	Professional	26	$23.71	$33.72	$61.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $81.01 / $146.94	Professional	TC	$53.70	$81.01	$146.94