Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $36.31 / $83.18	Facility	26	$15.85	$36.31	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $208.93	Professional		$69.18	$104.71	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $26.30 / $79.43	Professional	26	$15.14	$26.30	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $83.18 / $158.49	Professional	TC	$60.26	$83.18	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $173.78	Professional		$72.44	$79.43	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $22.39 / $31.62	Professional	26	$14.45	$22.39	$31.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $109.65 / $204.17	Professional		$81.28	$109.65	$204.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $38.02	Professional	26	$16.98	$23.44	$38.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $85.11 / $165.96	Professional	TC	$58.88	$85.11	$165.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $83.18 / $117.49	Professional		$18.62	$83.18	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $234.42	Professional		$77.62	$131.83	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $26.30 / $46.77	Professional	26	$15.49	$26.30	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $109.65 / $194.98	Professional	TC	$60.26	$109.65	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $354.81	Professional		$100.00	$131.83	$354.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $23.44 / $83.18	Professional	26	$18.20	$23.44	$83.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $107.15 / $354.81	Professional	TC	$81.28	$107.15	$354.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $91.20 / $165.96	Professional		$19.50	$91.20	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $204.17	Professional		$79.43	$109.65	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $38.90	Professional	26	$15.85	$21.88	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $89.13 / $165.96	Professional	TC	$63.10	$89.13	$165.96