Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.96 / $19.96 / $57.59	Facility	26	$19.96	$19.96	$57.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $46.00 / $164.16	Professional		$35.97	$46.00	$164.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.96 / $23.83 / $57.59	Professional	26	$19.96	$23.83	$57.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.42 / $17.85 / $97.42	Professional	TC	$15.42	$17.85	$97.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $63.41 / $176.73	Professional		$34.68	$63.41	$176.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $30.20 / $60.81	Professional	26	$20.23	$30.20	$60.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.02 / $91.31 / $265.35	Professional	50	$52.02	$91.31	$265.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $27.10 / $122.10	Professional	TC	$15.41	$27.10	$122.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $91.18 / $187.12	Professional		$35.65	$91.18	$187.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $37.14 / $69.97	Professional	26	$20.44	$37.14	$69.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.12 / $36.33 / $125.94	Professional	TC	$15.12	$36.33	$125.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.28 / $75.06 / $255.41	Professional		$41.28	$75.06	$255.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.44 / $40.79 / $97.00	Professional	26	$22.44	$40.79	$97.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $34.26 / $212.16	Professional	TC	$18.84	$34.26	$212.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $34.47 / $67.03	Professional		$20.57	$34.47	$67.03
United Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $64.90 / $186.47	Professional		$38.95	$64.90	$186.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.87 / $32.11 / $54.18	Professional	26	$21.87	$32.11	$54.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.88 / $26.45 / $123.51	Professional	TC	$15.88	$26.45	$123.51