Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $55.00 / $121.83	Facility	26	$55.00	$55.00	$121.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $232.05 / $455.00	Professional		$73.48	$232.05	$455.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.69 / $55.00 / $83.00	Professional	26	$26.69	$55.00	$83.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.13 / $157.18 / $264.00	Professional	TC	$48.13	$157.18	$264.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.02 / $76.02 / $76.02	Professional		$76.02	$76.02	$76.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $38.78 / $50.86	Professional	26	$21.97	$38.78	$50.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $128.01 / $128.01 / $128.01	Professional	TC	$128.01	$128.01	$128.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.27 / $125.95 / $284.39	Professional		$86.27	$125.95	$284.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $34.08 / $68.66	Professional	26	$26.09	$34.08	$68.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.10 / $84.21 / $179.14	Professional	TC	$58.10	$84.21	$179.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.04 / $79.45 / $145.53	Professional		$28.04	$79.45	$145.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.77 / $156.27 / $292.38	Professional		$90.77	$156.27	$292.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $44.42 / $81.75	Professional	26	$27.35	$44.42	$81.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.72 / $108.88 / $217.60	Professional	TC	$62.72	$108.88	$217.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $173.52 / $467.00	Professional		$108.85	$173.52	$467.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.29 / $46.70 / $107.41	Professional	26	$29.29	$46.70	$107.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.55 / $126.82 / $359.59	Professional	TC	$79.55	$126.82	$359.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.93 / $103.09 / $169.43	Professional		$37.93	$103.09	$169.43
United Facility/Professional Professional Modifier Low / Median / High Price $93.49 / $129.66 / $244.26	Professional		$93.49	$129.66	$244.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $36.47 / $64.88	Professional	26	$26.61	$36.47	$64.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.34 / $90.28 / $178.52	Professional	TC	$65.34	$90.28	$178.52