Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.89 / $30.01 / $147.13	Facility	26	$28.89	$30.01	$147.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.84 / $103.69 / $311.14	Professional		$84.84	$103.69	$311.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.01 / $36.03 / $84.47	Professional	26	$27.01	$36.03	$84.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.83 / $69.33 / $162.26	Professional	TC	$57.83	$69.33	$162.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.58 / $80.58 / $80.58	Professional		$80.58	$80.58	$80.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.99 / $45.30 / $59.71	Professional	26	$24.99	$45.30	$59.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.22 / $122.76 / $256.30	Professional		$99.22	$122.76	$256.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.95 / $39.27 / $76.72	Professional	26	$30.95	$39.27	$76.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.40 / $86.02 / $179.58	Professional	TC	$68.40	$86.02	$179.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $79.80 / $145.81	Professional		$33.79	$79.80	$145.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.97 / $162.69 / $294.49	Professional		$98.97	$162.69	$294.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.81 / $53.11 / $91.31	Professional	26	$33.81	$53.11	$91.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.41 / $112.16 / $206.98	Professional	TC	$70.41	$112.16	$206.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.25 / $183.72 / $951.72	Professional		$115.25	$183.72	$951.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.38 / $46.31 / $118.27	Professional	26	$35.38	$46.31	$118.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.86 / $104.54 / $266.95	Professional	TC	$79.86	$104.54	$266.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.52 / $108.10 / $193.82	Professional		$46.52	$108.10	$193.82
United Facility/Professional Professional Modifier Low / Median / High Price $100.67 / $137.62 / $234.99	Professional		$100.67	$137.62	$234.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $44.86 / $76.31	Professional	26	$32.83	$44.86	$76.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.40 / $94.55 / $163.52	Professional	TC	$69.40	$94.55	$163.52