Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.11 / $53.76 / $161.96	Facility	26	$32.11	$53.76	$161.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.58 / $105.29 / $233.45	Professional		$69.58	$105.29	$233.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.91 / $47.17 / $98.30	Professional	26	$30.91	$47.17	$98.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.34 / $54.81 / $130.85	Professional	TC	$38.34	$54.81	$130.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.44 / $99.62 / $154.34	Professional		$66.44	$99.62	$154.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.83 / $57.62 / $64.95	Professional	26	$28.83	$57.62	$64.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.64 / $55.52 / $81.58	Professional	TC	$40.64	$55.52	$81.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.81 / $113.13 / $204.42	Professional		$74.81	$113.13	$204.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.49 / $48.74 / $86.07	Professional	26	$32.49	$48.74	$86.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.04 / $64.41 / $120.47	Professional	TC	$43.04	$64.41	$120.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $56.19 / $107.19	Professional		$37.09	$56.19	$107.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $129.68 / $222.14	Professional		$85.80	$129.68	$222.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $54.59 / $97.22	Professional	26	$37.26	$54.59	$97.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.00 / $74.95 / $129.32	Professional	TC	$49.00	$74.95	$129.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.13 / $107.28 / $305.66	Professional		$83.13	$107.28	$305.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $45.49 / $128.65	Professional	26	$34.99	$45.49	$128.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.14 / $59.79 / $278.11	Professional	TC	$48.14	$59.79	$278.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $65.39 / $135.88	Professional		$34.36	$65.39	$135.88
United Facility/Professional Professional Modifier Low / Median / High Price $81.83 / $117.19 / $190.85	Professional		$81.83	$117.19	$190.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $48.05 / $81.20	Professional	26	$37.36	$48.05	$81.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.95 / $67.69 / $110.51	Professional	TC	$45.95	$67.69	$110.51