Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.13 / $48.56 / $136.69	Facility	26	$27.13	$48.56	$136.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $104.70 / $235.15	Professional		$67.73	$104.70	$235.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.48 / $47.77 / $84.95	Professional	26	$26.48	$47.77	$84.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.47 / $60.06 / $129.36	Professional	TC	$40.47	$60.06	$129.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $93.46 / $145.33	Professional		$61.11	$93.46	$145.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.63 / $42.01 / $55.44	Professional	26	$24.63	$42.01	$55.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.35 / $46.84 / $81.98	Professional	TC	$46.35	$46.84	$81.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $109.69 / $192.46	Professional		$71.81	$109.69	$192.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.45 / $41.34 / $72.89	Professional	26	$27.45	$41.34	$72.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.38 / $65.37 / $121.10	Professional	TC	$44.38	$65.37	$121.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $55.33 / $100.50	Professional		$30.73	$55.33	$100.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.11 / $35.11 / $35.11	Facility	26	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.89 / $123.19 / $214.02	Professional		$78.89	$123.19	$214.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $46.76 / $82.07	Professional	26	$31.12	$46.76	$82.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.36 / $77.12 / $130.90	Professional	TC	$50.36	$77.12	$130.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.28 / $100.65 / $287.81	Professional		$78.28	$100.65	$287.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $40.56 / $125.00	Professional	26	$29.86	$40.56	$125.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.42 / $60.09 / $240.02	Professional	TC	$48.42	$60.09	$240.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $58.28 / $128.30	Professional		$30.08	$58.28	$128.30
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.05 / $182.54	Professional		$79.43	$114.05	$182.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.47 / $40.86 / $67.83	Professional	26	$31.47	$40.86	$67.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.46 / $72.95 / $119.52	Professional	TC	$47.46	$72.95	$119.52