Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.23 / $55.60 / $157.51	Facility	26	$31.23	$55.60	$157.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.20 / $137.21 / $295.64	Professional		$78.20	$137.21	$295.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.87 / $54.52 / $96.50	Professional	26	$30.87	$54.52	$96.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $64.31 / $153.54	Professional	TC	$46.00	$64.31	$153.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $118.47 / $165.11	Professional		$69.45	$118.47	$165.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $48.36 / $63.83	Professional	26	$26.46	$48.36	$63.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.10 / $53.63 / $92.35	Professional	TC	$46.10	$53.63	$92.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.69 / $122.29 / $219.42	Professional		$82.69	$122.29	$219.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $47.25 / $84.82	Professional	26	$31.60	$47.25	$84.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.31 / $72.83 / $133.94	Professional	TC	$49.31	$72.83	$133.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $62.34 / $114.27	Professional		$35.40	$62.34	$114.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.50 / $139.83 / $244.38	Professional		$90.50	$139.83	$244.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.14 / $53.87 / $95.54	Professional	26	$36.14	$53.87	$95.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.33 / $87.29 / $148.62	Professional	TC	$56.33	$87.29	$148.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $114.38 / $327.00	Professional		$88.93	$114.38	$327.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.38 / $46.69 / $126.44	Professional	26	$34.38	$46.69	$126.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.54 / $67.69 / $261.22	Professional	TC	$54.54	$67.69	$261.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $67.33 / $146.13	Professional		$34.61	$67.33	$146.13
United Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $125.50 / $208.28	Professional		$92.46	$125.50	$208.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $47.00 / $83.86	Professional	26	$36.82	$47.00	$83.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.16 / $77.25 / $129.57	Professional	TC	$53.16	$77.25	$129.57