Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.10 / $91.00 / $135.13	Facility	26	$35.10	$91.00	$135.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $79.36 / $142.22	Professional		$59.50	$79.36	$142.22
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.26 / $38.88 / $82.86	Professional	26	$33.26	$38.88	$82.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $39.04 / $77.73	Professional	TC	$22.57	$39.04	$77.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.65 / $104.12 / $179.22	Professional		$79.65	$104.12	$179.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.60 / $50.88 / $64.79	Professional	26	$34.60	$50.88	$64.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.45 / $70.45 / $70.45	Professional	TC	$70.45	$70.45	$70.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.44 / $104.42 / $189.23	Professional		$59.44	$104.42	$189.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.49 / $62.60 / $105.30	Professional	26	$31.49	$62.60	$105.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.81 / $44.82 / $100.85	Professional	TC	$28.81	$44.82	$100.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.26 / $46.05 / $91.91	Professional		$37.26	$46.05	$91.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.23 / $95.31 / $216.06	Professional		$65.23	$95.31	$216.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.33 / $58.47 / $112.25	Professional	26	$39.33	$58.47	$112.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.64 / $37.29 / $115.29	Professional	TC	$23.64	$37.29	$115.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.52 / $97.53 / $404.00	Professional		$67.52	$97.53	$404.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.49 / $45.49 / $266.64	Professional	26	$31.49	$45.49	$266.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.03 / $52.04 / $137.36	Professional	TC	$36.03	$52.04	$137.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $83.67 / $156.79	Professional		$60.05	$83.67	$156.79
United Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $88.87 / $142.91	Professional		$62.23	$88.87	$142.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.69 / $52.20 / $78.52	Professional	26	$37.69	$52.20	$78.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $33.76 / $63.65	Professional	TC	$23.14	$33.76	$63.65