Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.89 / $73.76 / $209.50	Facility	26	$40.89	$73.76	$209.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.08 / $151.29 / $320.47	Professional		$98.08	$151.29	$320.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $55.48 / $134.51	Professional	26	$39.97	$55.48	$134.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.98 / $84.00 / $179.75	Professional	TC	$56.98	$84.00	$179.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.25 / $134.97 / $209.54	Professional		$88.25	$134.97	$209.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.19 / $66.08 / $84.31	Professional	26	$38.19	$66.08	$84.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.02 / $97.04 / $114.16	Professional	TC	$57.02	$97.04	$114.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.29 / $154.94 / $274.24	Professional		$105.29	$154.94	$274.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.78 / $62.23 / $110.26	Professional	26	$41.78	$62.23	$110.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.69 / $89.64 / $165.60	Professional	TC	$60.69	$89.64	$165.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.06 / $77.09 / $145.22	Professional		$48.06	$77.09	$145.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.62 / $53.62 / $53.62	Facility	26	$53.62	$53.62	$53.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $181.48 / $311.06	Professional		$111.50	$181.48	$311.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $71.16 / $125.29	Professional	26	$47.94	$71.16	$125.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $109.55 / $184.84	Professional	TC	$67.45	$109.55	$184.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.86 / $145.35 / $360.90	Professional		$112.86	$145.35	$360.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $59.03 / $166.99	Professional	26	$45.41	$59.03	$166.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.44 / $83.68 / $357.79	Professional	TC	$67.44	$83.68	$357.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.54 / $89.66 / $184.25	Professional		$45.54	$89.66	$184.25
United Facility/Professional Professional Modifier Low / Median / High Price $114.87 / $163.98 / $264.98	Professional		$114.87	$163.98	$264.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.90 / $62.54 / $103.52	Professional	26	$47.90	$62.54	$103.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.26 / $98.99 / $157.83	Professional	TC	$66.26	$98.99	$157.83