Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.50 / $28.00 / $124.84	Facility	26	$24.50	$28.00	$124.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.16 / $106.50 / $221.66	Professional		$85.16	$106.50	$221.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $28.00 / $67.38	Professional	26	$22.99	$28.00	$67.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.08 / $71.18 / $152.69	Professional	TC	$57.08	$71.18	$152.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $172.05 / $190.30	Professional		$79.19	$172.05	$190.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.83 / $40.13 / $52.72	Professional	26	$22.83	$40.13	$52.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $139.06 / $139.06 / $139.06	Professional	TC	$139.06	$139.06	$139.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $122.02 / $243.74	Professional		$92.25	$122.02	$243.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.84 / $34.50 / $65.70	Professional	26	$24.84	$34.50	$65.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.34 / $86.59 / $178.03	Professional	TC	$67.34	$86.59	$178.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $75.80 / $142.97	Professional		$28.36	$75.80	$142.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.38 / $153.16 / $268.86	Professional		$100.38	$153.16	$268.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.69 / $42.98 / $75.73	Professional	26	$29.69	$42.98	$75.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.56 / $110.21 / $193.69	Professional	TC	$74.56	$110.21	$193.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.50 / $121.12 / $872.00	Professional		$102.50	$121.12	$872.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $31.74 / $101.45	Professional	26	$27.60	$31.74	$101.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.90 / $86.14 / $275.37	Professional	TC	$74.90	$86.14	$275.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $122.37 / $185.22	Professional		$41.40	$122.37	$185.22
United Facility/Professional Professional Modifier Low / Median / High Price $100.04 / $138.44 / $233.44	Professional		$100.04	$138.44	$233.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.42 / $39.42 / $66.45	Professional	26	$29.42	$39.42	$66.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.55 / $100.04 / $169.65	Professional	TC	$71.55	$100.04	$169.65