Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.77 / $64.78 / $141.15	Facility	26	$27.77	$64.78	$141.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.05 / $145.22 / $459.84	Professional		$104.05	$145.22	$459.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.21 / $43.05 / $87.53	Professional	26	$27.21	$43.05	$87.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.93 / $99.56 / $214.81	Professional	TC	$76.93	$99.56	$214.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.13 / $230.13 / $262.50	Professional		$161.13	$230.13	$262.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.23 / $46.79 / $57.66	Professional	26	$28.23	$46.79	$57.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $186.24 / $186.24 / $186.24	Professional	TC	$186.24	$186.24	$186.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.74 / $155.04 / $407.75	Professional		$102.74	$155.04	$407.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.31 / $43.08 / $79.05	Professional	26	$28.31	$43.08	$79.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.15 / $119.14 / $343.41	Professional	TC	$73.15	$119.14	$343.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $161.43 / $265.26	Professional		$32.10	$161.43	$265.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.19 / $193.94 / $417.45	Professional		$109.19	$193.94	$417.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $48.53 / $85.29	Professional	26	$32.25	$48.53	$85.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.97 / $149.77 / $360.64	Professional	TC	$73.97	$149.77	$360.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.19 / $222.50 / $497.64	Professional		$190.19	$222.50	$497.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $42.27 / $116.96	Professional	26	$31.11	$42.27	$116.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.07 / $183.26 / $416.19	Professional	TC	$159.07	$183.26	$416.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $134.08 / $298.89	Professional		$37.33	$134.08	$298.89
United Facility/Professional Professional Modifier Low / Median / High Price $127.68 / $174.00 / $350.08	Professional		$127.68	$174.00	$350.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.86 / $43.97 / $73.02	Professional	26	$31.86	$43.97	$73.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.54 / $132.68 / $274.93	Professional	TC	$94.54	$132.68	$274.93