Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.68 / $38.68 / $71.69	Facility	26	$38.68	$38.68	$71.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.37 / $147.72 / $294.08	Professional		$108.37	$147.72	$294.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.68 / $46.41 / $103.60	Professional	26	$38.68	$46.41	$103.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.43 / $83.79 / $200.77	Professional	TC	$68.43	$83.79	$200.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.76 / $73.76 / $73.76	Professional	26	$73.76	$73.76	$73.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.44 / $168.57 / $306.83	Professional		$96.44	$168.57	$306.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $49.03 / $91.33	Professional	26	$34.90	$49.03	$91.33
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $144.66 / $253.81 / $482.20	Professional	50	$144.66	$253.81	$482.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.31 / $111.38 / $219.93	Professional	TC	$58.31	$111.38	$219.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.31 / $123.06 / $224.68	Professional		$42.31	$123.06	$224.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.99 / $153.18 / $315.06	Professional		$100.99	$153.18	$315.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.65 / $59.79 / $97.81	Professional	26	$38.65	$59.79	$97.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.66 / $98.39 / $237.33	Professional	TC	$55.66	$98.39	$237.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.61 / $203.01 / $419.67	Professional		$167.61	$203.01	$419.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.47 / $80.86 / $151.63	Professional	26	$44.47	$80.86	$151.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $123.15 / $167.93 / $308.36	Professional	TC	$123.15	$167.93	$308.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.65 / $168.62 / $277.08	Professional		$65.65	$168.62	$277.08
United Facility/Professional Professional Modifier Low / Median / High Price $99.15 / $147.81 / $282.14	Professional		$99.15	$147.81	$282.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.35 / $55.97 / $85.91	Professional	26	$42.35	$55.97	$85.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.43 / $89.48 / $202.19	Professional	TC	$55.43	$89.48	$202.19