Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.03 / $30.25 / $115.90	Facility	26	$23.03	$30.25	$115.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $103.42 / $263.70	Professional		$86.06	$103.42	$263.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.19 / $27.63 / $72.20	Professional	26	$22.19	$27.63	$72.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.31 / $73.70 / $175.27	Professional	TC	$60.31	$73.70	$175.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $192.01 / $192.01	Professional		$79.23	$192.01	$192.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $42.54 / $46.43	Professional	26	$21.08	$42.54	$46.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.94 / $119.34 / $249.17	Professional		$87.94	$119.34	$249.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.30 / $33.10 / $60.26	Professional	26	$23.30	$33.10	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.37 / $90.48 / $188.91	Professional	TC	$60.37	$90.48	$188.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $79.56 / $144.38	Professional		$25.75	$79.56	$144.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $143.78 / $253.38	Professional		$92.46	$143.78	$253.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $39.54 / $69.50	Professional	26	$27.46	$39.54	$69.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.01 / $104.46 / $192.10	Professional	TC	$68.01	$104.46	$192.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.42 / $124.10 / $455.00	Professional		$103.42	$124.10	$455.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.01 / $30.01 / $97.17	Professional	26	$25.01	$30.01	$97.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $78.41 / $90.32 / $288.27	Professional	TC	$78.41	$90.32	$288.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.92 / $125.00 / $239.53	Professional		$38.92	$125.00	$239.53
United Facility/Professional Professional Modifier Low / Median / High Price $96.76 / $133.32 / $237.45	Professional		$96.76	$133.32	$237.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.13 / $34.68 / $57.70	Professional	26	$26.13	$34.68	$57.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.02 / $95.47 / $180.02	Professional	TC	$70.02	$95.47	$180.02