Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.85 / $119.26 / $277.36	Facility	26	$50.85	$119.26	$277.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.07 / $162.68 / $472.00	Professional		$95.07	$162.68	$472.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.85 / $133.66 / $818.64	Professional	26	$50.85	$133.66	$818.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.90 / $83.90 / $209.13	Professional	TC	$47.90	$83.90	$209.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.23 / $129.01 / $195.97	Professional		$112.23	$129.01	$195.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.86 / $87.81 / $109.50	Professional	26	$56.86	$87.81	$109.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.22 / $185.83 / $357.72	Professional		$116.22	$185.83	$357.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.06 / $78.55 / $159.19	Professional	26	$56.06	$78.55	$159.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.52 / $102.33 / $202.42	Professional	TC	$61.52	$102.33	$202.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.44 / $121.30 / $259.32	Professional		$59.44	$121.30	$259.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.22 / $255.93 / $397.10	Professional		$144.22	$255.93	$397.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.97 / $104.86 / $181.10	Professional	26	$58.97	$104.86	$181.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.36 / $131.40 / $216.53	Professional	TC	$74.36	$131.40	$216.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.16 / $215.46 / $508.08	Professional		$135.16	$215.46	$508.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.88 / $103.43 / $165.80	Professional	26	$64.88	$103.43	$165.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.29 / $112.06 / $508.08	Professional	TC	$70.29	$112.06	$508.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.32 / $109.11 / $227.89	Professional		$84.32	$109.11	$227.89
United Facility/Professional Professional Modifier Low / Median / High Price $120.35 / $182.14 / $327.73	Professional		$120.35	$182.14	$327.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.48 / $77.86 / $138.29	Professional	26	$56.48	$77.86	$138.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.23 / $107.76 / $172.75	Professional	TC	$64.23	$107.76	$172.75