Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.17 / $41.33 / $114.34	Facility	26	$23.17	$41.33	$114.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.04 / $100.73 / $161.05	Professional		$86.04	$100.73	$161.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $31.40 / $171.14	Professional	26	$23.17	$31.40	$171.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.37 / $83.70 / $135.44	Professional	TC	$64.37	$83.70	$135.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.67 / $223.55 / $223.55	Professional		$56.67	$223.55	$223.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.36 / $31.88 / $54.89	Professional	26	$15.36	$31.88	$54.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $41.31 / $41.31	Professional	TC	$41.31	$41.31	$41.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $54.00 / $257.55	Professional		$54.00	$54.00	$257.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $14.69 / $63.25	Professional	26	$13.70	$14.69	$63.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.31 / $39.31 / $194.31	Professional	TC	$39.31	$39.31	$194.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $70.08 / $411.61	Professional		$47.40	$70.08	$411.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.60 / $18.35 / $98.32	Professional	26	$13.60	$18.35	$98.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.46 / $52.08 / $289.05	Professional	TC	$33.46	$52.08	$289.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.96 / $215.35 / $1,125.81	Professional		$124.96	$215.35	$1,125.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.71 / $58.37 / $272.10	Professional	26	$31.71	$58.37	$272.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.24 / $156.97 / $853.71	Professional	TC	$93.24	$156.97	$853.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $119.01 / $213.27	Professional		$36.47	$119.01	$213.27
United Facility/Professional Professional Modifier Low / Median / High Price $79.89 / $133.27 / $287.27	Professional		$79.89	$133.27	$287.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $36.07 / $72.23	Professional	26	$20.95	$36.07	$72.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.32 / $95.82 / $209.78	Professional	TC	$60.32	$95.82	$209.78