Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.60 / $41.88 / $144.12	Facility	26	$28.60	$41.88	$144.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $132.12 / $285.73	Professional		$88.85	$132.12	$285.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.93 / $44.10 / $89.51	Professional	26	$27.93	$44.10	$89.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.85 / $87.72 / $195.70	Professional	TC	$58.85	$87.72	$195.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.78 / $120.50 / $188.52	Professional		$78.78	$120.50	$188.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $44.30 / $60.13	Professional	26	$24.20	$44.30	$60.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.82 / $80.78 / $124.02	Professional	TC	$52.82	$80.78	$124.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $134.44 / $255.72	Professional		$91.38	$134.44	$255.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $43.57 / $77.65	Professional	26	$28.93	$43.57	$77.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.34 / $89.43 / $177.60	Professional	TC	$60.34	$89.43	$177.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.42 / $70.89 / $141.00	Professional		$32.42	$70.89	$141.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $158.41 / $271.26	Professional		$99.13	$158.41	$271.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $49.22 / $86.56	Professional	26	$31.83	$49.22	$86.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.37 / $110.33 / $189.82	Professional	TC	$64.37	$110.33	$189.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.54 / $129.77 / $350.00	Professional		$101.54	$129.77	$350.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $42.77 / $140.00	Professional	26	$31.48	$42.77	$140.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.06 / $87.00 / $257.62	Professional	TC	$70.06	$87.00	$257.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $91.39 / $166.84	Professional		$37.78	$91.39	$166.84
United Facility/Professional Professional Modifier Low / Median / High Price $101.64 / $139.35 / $234.53	Professional		$101.64	$139.35	$234.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.21 / $43.95 / $74.76	Professional	26	$32.21	$43.95	$74.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.86 / $99.27 / $163.00	Professional	TC	$68.86	$99.27	$163.00