Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $87.10 / $218.78	Facility	26	$32.36	$87.10	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $275.42	Professional		$72.44	$100.00	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $43.65 / $190.55	Professional	26	$16.98	$43.65	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $57.54 / $199.53	Professional	TC	$40.74	$57.54	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $46.77 / $83.18	Professional	26	$33.88	$46.77	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $199.53 / $660.69	Professional		$95.50	$199.53	$660.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $26.30 / $69.18	Professional	26	$17.78	$26.30	$69.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $154.88 / $645.65	Professional	TC	$63.10	$154.88	$645.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $117.49	Professional		$45.71	$60.26	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $194.98 / $645.65	Professional		$77.62	$194.98	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $33.88 / $107.15	Professional	26	$18.62	$33.88	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $123.03 / $501.19	Professional	TC	$52.48	$123.03	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $912.01	Professional		$97.72	$125.89	$912.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $53.70 / $114.82	Professional	26	$44.67	$53.70	$114.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $67.61 / $870.96	Professional	TC	$51.29	$67.61	$870.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $169.82	Professional		$72.44	$81.28	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $478.63	Professional		$93.33	$162.18	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $44.67 / $95.50	Professional	26	$17.78	$44.67	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $95.50 / $467.74	Professional	TC	$53.70	$95.50	$467.74