Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.79 / $65.41 / $190.18	Facility	26	$36.79	$65.41	$190.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $131.53 / $365.18	Professional		$109.14	$131.53	$365.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $48.41 / $107.39	Professional	26	$31.76	$48.41	$107.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.95 / $89.70 / $225.15	Professional	TC	$74.95	$89.70	$225.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.57 / $107.65 / $107.65	Professional		$101.57	$107.65	$107.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $57.58 / $75.92	Professional	26	$33.75	$57.58	$75.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.04 / $156.08 / $324.82	Professional		$110.04	$156.08	$324.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $49.72 / $103.26	Professional	26	$35.35	$49.72	$103.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.28 / $108.34 / $226.20	Professional	TC	$71.28	$108.34	$226.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.21 / $100.36 / $183.30	Professional		$43.21	$100.36	$183.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.30 / $189.26 / $352.97	Professional		$109.30	$189.26	$352.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.57 / $60.01 / $106.10	Professional	26	$34.57	$60.01	$106.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.67 / $133.75 / $246.52	Professional	TC	$73.67	$133.75	$246.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $145.41 / $231.83 / $486.08	Professional		$145.41	$231.83	$486.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.98 / $71.70 / $150.35	Professional	26	$44.98	$71.70	$150.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $100.44 / $160.12 / $335.73	Professional	TC	$100.44	$160.12	$335.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $130.60 / $229.81	Professional		$44.47	$130.60	$229.81
United Facility/Professional Professional Modifier Low / Median / High Price $112.60 / $166.57 / $300.35	Professional		$112.60	$166.57	$300.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $49.39 / $87.76	Professional	26	$35.35	$49.39	$87.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.81 / $113.24 / $201.32	Professional	TC	$76.81	$113.24	$201.32