Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.96 / $39.89 / $205.05	Facility	26	$27.96	$39.89	$205.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $126.16 / $347.78	Professional		$78.98	$126.16	$347.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $41.30 / $180.00	Professional	26	$16.71	$41.30	$180.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.18 / $63.90 / $315.31	Professional	TC	$41.18	$63.90	$315.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $59.00 / $89.00	Professional	26	$36.72	$59.00	$89.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.39 / $163.59 / $651.23	Professional		$92.39	$163.59	$651.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $41.34 / $106.72	Professional	26	$19.47	$41.34	$106.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.40 / $95.72 / $651.27	Professional	TC	$49.40	$95.72	$651.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.67 / $67.34 / $120.60	Professional		$45.67	$67.34	$120.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	26	$52.72	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.62 / $215.80 / $731.10	Professional		$84.62	$215.80	$731.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $36.08 / $121.48	Professional	26	$18.82	$36.08	$121.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.62 / $139.37 / $522.48	Professional	TC	$62.62	$139.37	$522.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.29 / $185.98 / $1,175.83	Professional		$102.29	$185.98	$1,175.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.25 / $53.10 / $188.37	Professional	26	$44.25	$53.10	$188.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $53.61 / $97.48 / $1,175.83	Professional	TC	$53.61	$97.48	$1,175.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.54 / $87.73 / $175.06	Professional		$73.54	$87.73	$175.06
United Facility/Professional Professional Modifier Low / Median / High Price $96.43 / $169.82 / $480.18	Professional		$96.43	$169.82	$480.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.75 / $45.27 / $94.62	Professional	26	$18.75	$45.27	$94.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.75 / $95.86 / $438.10	Professional	TC	$54.75	$95.86	$438.10