Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.71 / $35.02 / $78.73	Facility	26	$15.71	$35.02	$78.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.65 / $105.51 / $231.69	Professional		$81.65	$105.51	$231.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $19.43 / $53.04	Professional	26	$14.98	$19.43	$53.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.86 / $85.32 / $168.06	Professional	TC	$63.86	$85.32	$168.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $79.98 / $157.69	Professional		$72.06	$79.98	$157.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $25.76 / $32.71	Professional	26	$14.60	$25.76	$32.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.30 / $115.23 / $241.59	Professional		$75.30	$115.23	$241.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $23.69 / $47.30	Professional	26	$16.71	$23.69	$47.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.52 / $91.34 / $194.80	Professional	TC	$59.52	$91.34	$194.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $88.18 / $153.55	Professional		$18.57	$88.18	$153.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.64 / $147.72 / $254.57	Professional		$81.64	$147.72	$254.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.87 / $29.51 / $48.06	Professional	26	$17.87	$29.51	$48.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.89 / $119.42 / $199.30	Professional	TC	$62.89	$119.42	$199.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.09 / $141.13 / $355.39	Professional		$94.09	$141.13	$355.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $26.43 / $83.90	Professional	26	$17.62	$26.43	$83.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.47 / $114.71 / $355.39	Professional	TC	$76.47	$114.71	$355.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $94.52 / $155.97	Professional		$20.78	$94.52	$155.97
United Facility/Professional Professional Modifier Low / Median / High Price $82.99 / $122.50 / $205.96	Professional		$82.99	$122.50	$205.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.64 / $22.91 / $38.36	Professional	26	$16.64	$22.91	$38.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.81 / $94.71 / $168.04	Professional	TC	$62.81	$94.71	$168.04