Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $89.13 / $213.80	Facility	26	$40.74	$89.13	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $223.87 / $501.19	Professional		$114.82	$223.87	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $79.43 / $194.98	Professional	26	$39.81	$79.43	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $100.00 / $199.53	Professional	TC	$70.79	$100.00	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $223.87	Professional		$93.33	$117.49	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $85.11	Professional	26	$38.02	$50.12	$85.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $102.33	Professional	TC	$48.98	$74.13	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $288.40	Professional		$134.90	$177.83	$288.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $109.65	Professional	26	$50.12	$66.07	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $117.49 / $181.97	Professional	TC	$85.11	$117.49	$181.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $93.33 / $165.96	Professional		$47.86	$93.33	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $323.59	Professional		$125.89	$190.55	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $117.49	Professional	26	$46.77	$69.18	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $125.89 / $218.78	Professional	TC	$81.28	$125.89	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $436.52	Professional		$138.04	$165.96	$436.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $57.54 / $151.36	Professional	26	$47.86	$57.54	$151.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $109.65 / $338.84	Professional	TC	$91.20	$109.65	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $120.23 / $213.80	Professional		$51.29	$120.23	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $302.00	Professional		$128.82	$173.78	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $60.26 / $104.71	Professional	26	$46.77	$60.26	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $109.65 / $194.98	Professional	TC	$83.18	$109.65	$194.98