Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $67.61 / $162.18	Facility	26	$30.90	$67.61	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $158.49 / $467.74	Professional		$81.28	$158.49	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $66.07 / $165.96	Professional	26	$30.90	$66.07	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $66.07 / $169.82	Professional	TC	$45.71	$66.07	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $151.36	Professional		$64.57	$83.18	$151.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $41.69 / $61.66	Professional	26	$27.54	$41.69	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $89.13	Professional	TC	$42.66	$52.48	$89.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $199.53	Professional		$95.50	$125.89	$199.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $79.43	Professional	26	$38.02	$50.12	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $75.86 / $114.82	Professional	TC	$60.26	$75.86	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $60.26 / $112.20	Professional		$36.31	$60.26	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $234.42	Professional		$85.11	$134.90	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $51.29 / $89.13	Professional	26	$35.48	$51.29	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $83.18 / $144.54	Professional	TC	$54.95	$83.18	$144.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $323.59	Professional		$93.33	$112.20	$323.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $42.66 / $125.89	Professional	26	$36.31	$42.66	$125.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $70.79 / $263.03	Professional	TC	$58.88	$70.79	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $79.43 / $144.54	Professional		$38.02	$79.43	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $204.17	Professional		$89.13	$120.23	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $79.43	Professional	26	$34.67	$45.71	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $75.86 / $125.89	Professional	TC	$53.70	$75.86	$125.89