Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $67.61 / $138.04	Facility	26	$33.88	$67.61	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $173.78	Professional		$53.70	$72.44	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.84 / $69.18	Professional	26	$21.88	$28.84	$69.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $223.87 / $489.78	Professional	50	$66.07	$223.87	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $83.18	Professional	TC	$26.92	$38.02	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $53.70 / $91.20	Professional		$50.12	$53.70	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.12 / $50.12	Professional	26	$21.88	$25.12	$50.12
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	50	$169.82	$169.82	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $162.18	Professional		$69.18	$95.50	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $64.57	Professional	26	$28.18	$38.02	$64.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $104.71 / $144.54 / $239.88	Professional	50	$104.71	$144.54	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $56.23 / $100.00	Professional	TC	$39.81	$56.23	$100.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $77.62	Professional		$30.20	$41.69	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $169.82	Professional		$61.66	$102.33	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $74.13	Professional	26	$28.18	$41.69	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $60.26 / $104.71	Professional	TC	$35.48	$60.26	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $239.88	Professional		$70.79	$85.11	$239.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $36.31 / $95.50	Professional	26	$30.20	$36.31	$95.50
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $60.26 / $60.26 / $85.11	Professional	52	$60.26	$60.26	$85.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $47.86 / $190.55	Professional	TC	$39.81	$47.86	$190.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $213.80	Professional		$95.50	$177.83	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $151.36	Professional		$63.10	$89.13	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $36.31 / $64.57	Professional	26	$28.84	$36.31	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $53.70 / $87.10	Professional	TC	$33.11	$53.70	$87.10