Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $74.73 / $167.89	Facility	26	$55.00	$74.73	$167.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $198.29 / $330.00	Professional		$83.73	$198.29	$330.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.17 / $55.00 / $122.00	Professional	26	$36.17	$55.00	$122.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.19 / $119.70 / $242.00	Professional	TC	$43.19	$119.70	$242.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.52 / $92.87 / $92.87	Professional		$65.52	$92.87	$92.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $67.40 / $74.19	Professional	26	$31.50	$67.40	$74.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $104.60 / $274.57	Professional		$64.05	$104.60	$274.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $49.58 / $104.67	Professional	26	$34.64	$49.58	$104.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.93 / $55.11 / $160.65	Professional	TC	$29.93	$55.11	$160.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $55.94 / $99.73	Professional		$36.57	$55.94	$99.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $145.99 / $258.32	Professional		$70.62	$145.99	$258.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.18 / $60.61 / $101.93	Professional	26	$37.18	$60.61	$101.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $78.08 / $158.81	Professional	TC	$32.86	$78.08	$158.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.79 / $135.16 / $649.72	Professional		$84.79	$135.16	$649.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $63.78 / $207.11	Professional	26	$40.01	$63.78	$207.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $44.79 / $71.41 / $649.72	Professional	TC	$44.79	$71.41	$649.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $67.39 / $141.72	Professional		$38.29	$67.39	$141.72
United Facility/Professional Professional Modifier Low / Median / High Price $69.75 / $113.49 / $222.86	Professional		$69.75	$113.49	$222.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.68 / $52.21 / $89.81	Professional	26	$36.68	$52.21	$89.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.77 / $55.21 / $141.02	Professional	TC	$29.77	$55.21	$141.02