Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.03 / $47.59 / $117.38	Facility	26	$23.03	$47.59	$117.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.65 / $101.31 / $261.68	Professional		$73.65	$101.31	$261.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $27.63 / $74.53	Professional	26	$22.46	$27.63	$74.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.12 / $69.26 / $154.99	Professional	TC	$52.12	$69.26	$154.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.55 / $77.92 / $178.33	Professional		$64.55	$77.92	$178.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $36.89 / $51.69	Professional	26	$21.32	$36.89	$51.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.57 / $117.45 / $238.94	Professional		$82.57	$117.45	$238.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $34.34 / $69.37	Professional	26	$24.07	$34.34	$69.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.98 / $82.34 / $171.92	Professional	TC	$57.98	$82.34	$171.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $147.02 / $260.39	Professional		$86.98	$147.02	$260.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $41.69 / $71.95	Professional	26	$25.11	$41.69	$71.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $105.04 / $182.98	Professional	TC	$61.88	$105.04	$182.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.66 / $168.43 / $353.16	Professional		$105.66	$168.43	$353.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.87 / $44.44 / $94.70	Professional	26	$27.87	$44.44	$94.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.78 / $124.00 / $260.00	Professional	TC	$77.78	$124.00	$260.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $106.91 / $180.69	Professional		$35.47	$106.91	$180.69
United Facility/Professional Professional Modifier Low / Median / High Price $87.05 / $120.32 / $205.80	Professional		$87.05	$120.32	$205.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.81 / $34.46 / $57.02	Professional	26	$24.81	$34.46	$57.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.54 / $86.91 / $149.31	Professional	TC	$60.54	$86.91	$149.31