Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $83.18 / $154.88	Facility	26	$28.84	$83.18	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $323.59	Professional		$85.11	$112.20	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $43.65 / $114.82	Professional	26	$28.18	$43.65	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $74.13 / $162.18	Professional	TC	$58.88	$74.13	$162.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $57.54	Professional	26	$26.92	$43.65	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $190.55	Professional		$107.15	$123.03	$190.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.90 / $61.66	Professional	26	$33.88	$38.90	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $83.18 / $134.90	Professional	TC	$72.44	$83.18	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $79.43 / $131.83	Professional		$33.88	$79.43	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $269.15	Professional		$87.10	$151.36	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $50.12 / $87.10	Professional	26	$28.84	$50.12	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $104.71 / $186.21	Professional	TC	$63.10	$104.71	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $691.83	Professional		$107.15	$138.04	$691.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $85.11	Professional	26	$32.36	$42.66	$85.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $91.20 / $194.98	Professional	TC	$74.13	$91.20	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $81.28 / $177.83	Professional		$33.11	$81.28	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $234.42	Professional		$100.00	$131.83	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $41.69 / $74.13	Professional	26	$32.36	$41.69	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $89.13 / $158.49	Professional	TC	$69.18	$89.13	$158.49