Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $123.03 / $275.42	Facility	26	$51.29	$123.03	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $194.98 / $794.33	Professional		$102.33	$194.98	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $147.91 / $758.58	Professional	26	$53.70	$147.91	$758.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $83.18 / $208.93	Professional	TC	$51.29	$83.18	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $100.00 / $147.91	Professional		$91.20	$100.00	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $109.65	Professional	26	$47.86	$61.66	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $331.13	Professional		$125.89	$199.53	$331.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $138.04	Professional	26	$56.23	$79.43	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $114.82 / $190.55	Professional	TC	$67.61	$114.82	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $269.15	Professional		$79.43	$131.83	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $245.47 / $389.05	Professional		$131.83	$245.47	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $97.72 / $177.83	Professional	26	$58.88	$97.72	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $128.82 / $204.17	Professional	TC	$64.57	$128.82	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $478.63	Professional		$141.25	$165.96	$478.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $165.96	Professional	26	$67.61	$79.43	$165.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $87.10 / $446.68	Professional	TC	$74.13	$87.10	$446.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $97.72 / $199.53	Professional		$85.11	$97.72	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $331.13	Professional		$128.82	$181.97	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $151.36	Professional	26	$56.23	$74.13	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $107.15 / $173.78	Professional	TC	$66.07	$107.15	$173.78