Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.21 / $69.45 / $151.53	Facility	26	$27.21	$69.45	$151.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $79.14 / $238.84	Professional		$58.91	$79.14	$238.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.15 / $29.80 / $74.12	Professional	26	$25.15	$29.80	$74.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.76 / $41.26 / $117.39	Professional	TC	$33.76	$41.26	$117.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.12 / $111.56 / $209.02	Professional		$71.12	$111.56	$209.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.40 / $43.68 / $78.20	Professional	26	$28.40	$43.68	$78.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $106.54 / $167.48 / $313.52	Professional	50	$106.54	$167.48	$313.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $64.67 / $123.31	Professional	TC	$41.00	$64.67	$123.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Facility	26	$36.24	$36.24	$36.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.22 / $131.63 / $202.29	Professional		$79.22	$131.63	$202.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $49.03 / $85.37	Professional	26	$33.40	$49.03	$85.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.87 / $80.70 / $125.89	Professional	TC	$49.87	$80.70	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $92.57 / $264.95	Professional		$72.06	$92.57	$264.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.06 / $40.38 / $103.43	Professional	26	$31.06	$40.38	$103.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $50.89 / $257.47	Professional	TC	$41.00	$50.89	$257.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $133.19 / $185.10 / $223.00	Professional		$133.19	$185.10	$223.00
United Facility/Professional Professional Modifier Low / Median / High Price $88.10 / $121.51 / $202.82	Professional		$88.10	$121.51	$202.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.99 / $45.18 / $73.62	Professional	26	$33.99	$45.18	$73.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.81 / $75.87 / $125.81	Professional	TC	$54.81	$75.87	$125.81