Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.33 / $81.93 / $178.31	Facility	26	$35.33	$81.93	$178.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $137.09 / $300.56	Professional		$90.89	$137.09	$300.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $54.95 / $118.81	Professional	26	$34.34	$54.95	$118.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $66.93 / $161.41	Professional	TC	$51.97	$66.93	$161.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $119.29 / $183.89	Professional		$81.84	$119.29	$183.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.00 / $53.84 / $72.17	Professional	26	$32.00	$53.84	$72.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.92 / $79.15 / $111.98	Professional	TC	$55.92	$79.15	$111.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.13 / $135.05 / $256.91	Professional		$86.13	$135.05	$256.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $53.83 / $93.64	Professional	26	$35.43	$53.83	$93.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.90 / $80.97 / $163.27	Professional	TC	$50.90	$80.97	$163.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $75.62 / $134.81	Professional		$41.20	$75.62	$134.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.92 / $155.53 / $272.33	Professional		$93.92	$155.53	$272.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.26 / $60.69 / $108.96	Professional	26	$40.26	$60.69	$108.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.42 / $96.46 / $172.93	Professional	TC	$56.42	$96.46	$172.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.02 / $126.02 / $350.00	Professional		$105.02	$126.02	$350.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $50.53 / $153.56	Professional	26	$38.86	$50.53	$153.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $66.15 / $79.38 / $243.25	Professional	TC	$66.15	$79.38	$243.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $82.08 / $172.23	Professional		$39.90	$82.08	$172.23
United Facility/Professional Professional Modifier Low / Median / High Price $101.33 / $139.35 / $244.82	Professional		$101.33	$139.35	$244.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.71 / $56.06 / $92.24	Professional	26	$41.71	$56.06	$92.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.39 / $86.37 / $155.57	Professional	TC	$58.39	$86.37	$155.57