Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $57.54 / $128.82	Facility	26	$52.48	$57.54	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $151.36 / $380.19	Professional		$72.44	$151.36	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $51.29 / $95.50	Professional	26	$25.70	$51.29	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $97.72 / $239.88	Professional	TC	$47.86	$97.72	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $109.65	Professional		$67.61	$81.28	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $36.31 / $47.86	Professional	26	$20.89	$36.31	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $251.19	Professional		$87.10	$125.89	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $56.23	Professional	26	$27.54	$35.48	$56.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $85.11 / $144.54	Professional	TC	$60.26	$85.11	$144.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $79.43 / $125.89	Professional		$28.18	$79.43	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $154.88 / $309.03	Professional		$91.20	$154.88	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $41.69 / $83.18	Professional	26	$25.12	$41.69	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $109.65 / $208.93	Professional	TC	$63.10	$109.65	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $363.08	Professional		$102.33	$131.83	$363.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $35.48 / $104.71	Professional	26	$26.92	$35.48	$104.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $95.50 / $263.03	Professional	TC	$74.13	$95.50	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $79.43 / $169.82	Professional		$27.54	$79.43	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $229.09	Professional		$91.20	$117.49	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.88 / $63.10	Professional	26	$25.70	$33.88	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $85.11 / $162.18	Professional	TC	$64.57	$85.11	$162.18