Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.15 / $39.26 / $111.45	Facility	26	$22.15	$39.26	$111.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.73 / $114.27 / $331.91	Professional		$89.73	$114.27	$331.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.83 / $27.68 / $75.00	Professional	26	$21.83	$27.68	$75.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $90.72 / $196.55	Professional	TC	$67.84	$90.72	$196.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $35.49 / $49.71	Professional	26	$18.93	$35.49	$49.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $139.44 / $291.12	Professional		$86.75	$139.44	$291.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.57 / $34.59 / $66.95	Professional	26	$23.57	$34.59	$66.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.51 / $111.32 / $232.42	Professional	TC	$65.51	$111.32	$232.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.61 / $102.85 / $179.91	Professional		$25.61	$102.85	$179.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $28.92	Facility	26	$28.92	$28.92	$28.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $153.13 / $320.77	Professional		$86.54	$153.13	$320.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.38 / $40.75 / $68.12	Professional	26	$24.38	$40.75	$68.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $114.27 / $253.25	Professional	TC	$59.00	$114.27	$253.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.72 / $184.88 / $445.97	Professional		$129.72	$184.88	$445.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $42.74 / $93.47	Professional	26	$26.81	$42.74	$93.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $102.93 / $160.47 / $352.50	Professional	TC	$102.93	$160.47	$352.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $140.94 / $225.80	Professional		$36.06	$140.94	$225.80
United Facility/Professional Professional Modifier Low / Median / High Price $88.36 / $142.82 / $262.27	Professional		$88.36	$142.82	$262.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.83 / $32.76 / $57.65	Professional	26	$23.83	$32.76	$57.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.02 / $111.31 / $208.18	Professional	TC	$61.02	$111.31	$208.18