Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.55 / $38.29 / $133.74	Facility	26	$26.55	$38.29	$133.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $136.76 / $276.44	Professional		$82.89	$136.76	$276.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.25 / $42.18 / $87.46	Professional	26	$26.25	$42.18	$87.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.86 / $75.08 / $137.00	Professional	TC	$53.86	$75.08	$137.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $136.72 / $179.53	Professional		$74.98	$136.72	$179.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $41.12 / $55.79	Professional	26	$22.43	$41.12	$55.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.98 / $61.66 / $119.46	Professional	TC	$31.98	$61.66	$119.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.41 / $119.16 / $249.13	Professional		$76.41	$119.16	$249.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.86 / $40.44 / $72.08	Professional	26	$26.86	$40.44	$72.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.25 / $78.58 / $175.04	Professional	TC	$48.25	$78.58	$175.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.83 / $68.26 / $135.12	Professional		$30.83	$68.26	$135.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $139.72 / $244.59	Professional		$80.59	$139.72	$244.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $45.74 / $80.28	Professional	26	$29.54	$45.74	$80.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.03 / $96.92 / $176.24	Professional	TC	$46.03	$96.92	$176.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $120.00 / $275.39	Professional		$96.70	$120.00	$275.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.21 / $39.70 / $113.12	Professional	26	$29.21	$39.70	$113.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $83.79 / $248.69	Professional	TC	$67.48	$83.79	$248.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $94.49 / $165.74	Professional		$38.90	$94.49	$165.74
United Facility/Professional Professional Modifier Low / Median / High Price $89.96 / $130.52 / $227.94	Professional		$89.96	$130.52	$227.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.19 / $40.77 / $66.33	Professional	26	$30.19	$40.77	$66.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.81 / $86.20 / $156.33	Professional	TC	$56.81	$86.20	$156.33