Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.18 / $68.00 / $145.19	Facility	26	$29.18	$68.00	$145.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.38 / $155.38 / $247.22	Professional		$123.38	$155.38	$247.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $48.51 / $133.68	Professional	26	$29.18	$48.51	$133.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.01 / $113.05 / $272.57	Professional	TC	$71.01	$113.05	$272.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.33 / $76.33 / $283.43	Professional		$76.33	$76.33	$283.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $69.44 / $76.63	Professional	26	$19.41	$69.44	$76.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.92 / $56.92 / $227.91	Professional	TC	$56.92	$56.92	$227.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $73.44 / $342.57	Professional		$73.44	$73.44	$342.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $22.60 / $99.84	Professional	26	$22.60	$22.60	$99.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.95 / $54.86 / $192.41	Professional	TC	$50.95	$54.86	$192.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $140.83 / $189.53	Professional		$40.11	$140.83	$189.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.64 / $91.01 / $522.52	Professional		$70.64	$91.01	$522.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $29.99 / $124.64	Professional	26	$21.17	$29.99	$124.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.04 / $68.97 / $398.16	Professional	TC	$40.04	$68.97	$398.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.55 / $290.05 / $1,449.07	Professional		$168.55	$290.05	$1,449.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $73.78 / $342.62	Professional	26	$40.11	$73.78	$342.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $128.44 / $216.28 / $1,106.44	Professional	TC	$128.44	$216.28	$1,106.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.14 / $160.87 / $287.23	Professional		$46.14	$160.87	$287.23
United Facility/Professional Professional Modifier Low / Median / High Price $101.69 / $179.97 / $387.50	Professional		$101.69	$179.97	$387.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $50.42 / $106.18	Professional	26	$27.50	$50.42	$106.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.59 / $133.65 / $288.92	Professional	TC	$67.59	$133.65	$288.92