Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $48.98 / $107.15	Facility	26	$19.95	$48.98	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $53.70 / $151.36	Professional		$30.90	$53.70	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $39.81 / $69.18	Professional	26	$19.95	$39.81	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $21.38 / $87.10	Professional	TC	$10.96	$21.38	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $66.07	Professional		$35.48	$44.67	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.20 / $44.67	Professional	26	$21.88	$30.20	$44.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $87.10 / $138.04	Professional		$43.65	$87.10	$138.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $34.67 / $54.95	Professional	26	$23.44	$34.67	$54.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $52.48 / $87.10	Professional	TC	$18.62	$52.48	$87.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $34.67 / $87.10	Professional		$20.42	$34.67	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $102.33 / $158.49	Professional		$45.71	$102.33	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $39.81 / $70.79	Professional	26	$25.12	$39.81	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $51.29 / $97.72	Professional	TC	$16.60	$51.29	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $213.80	Professional		$45.71	$53.70	$213.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $72.44	Professional	26	$26.30	$30.90	$72.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.39 / $190.55	Professional	TC	$19.05	$22.39	$190.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $66.07	Professional		$23.99	$33.88	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $81.28 / $120.23	Professional		$44.67	$81.28	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $60.26	Professional	26	$23.99	$30.90	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $47.86 / $70.79	Professional	TC	$18.20	$47.86	$70.79