Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.99 / $52.79 / $170.86	Facility	26	$32.99	$52.79	$170.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $118.38 / $538.44	Professional		$93.87	$118.38	$538.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $53.63 / $109.54	Professional	26	$30.83	$53.63	$109.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.04 / $77.05 / $187.24	Professional	TC	$63.04	$77.05	$187.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $121.55 / $121.55	Professional		$121.55	$121.55	$121.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $53.85 / $70.69	Professional	26	$31.13	$53.85	$70.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.35 / $141.63 / $286.62	Professional		$96.35	$141.63	$286.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $48.78 / $100.98	Professional	26	$33.29	$48.78	$100.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.70 / $94.95 / $198.23	Professional	TC	$61.70	$94.95	$198.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $87.95 / $160.66	Professional		$39.00	$87.95	$160.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $43.57 / $43.57	Facility	26	$43.57	$43.57	$43.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.17 / $169.41 / $308.42	Professional		$98.17	$169.41	$308.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.27 / $55.95 / $100.32	Professional	26	$33.27	$55.95	$100.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.87 / $116.39 / $215.10	Professional	TC	$62.87	$116.39	$215.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $205.22 / $430.31	Professional		$128.72	$205.22	$430.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.71 / $64.90 / $136.09	Professional	26	$40.71	$64.90	$136.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $88.02 / $140.32 / $294.24	Professional	TC	$88.02	$140.32	$294.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $117.44 / $207.18	Professional		$40.17	$117.44	$207.18
United Facility/Professional Professional Modifier Low / Median / High Price $102.11 / $138.43 / $255.10	Professional		$102.11	$138.43	$255.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.90 / $46.16 / $83.00	Professional	26	$33.90	$46.16	$83.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.26 / $96.82 / $176.42	Professional	TC	$66.26	$96.82	$176.42