Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.22 / $74.47 / $151.04	Facility	26	$39.22	$74.47	$151.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.54 / $83.98 / $168.59	Professional		$65.54	$83.98	$168.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $45.22 / $89.49	Professional	26	$38.01	$45.22	$89.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $39.71 / $79.00	Professional	TC	$26.17	$39.71	$79.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $141.44 / $190.73	Professional		$96.30	$141.44	$190.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.04 / $69.04 / $72.83	Professional	26	$69.04	$69.04	$72.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	TC	$71.59	$71.59	$71.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.36 / $113.62 / $201.99	Professional		$69.36	$113.62	$201.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.29 / $70.45 / $122.77	Professional	26	$35.29	$70.45	$122.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $46.37 / $102.44	Professional	TC	$29.51	$46.37	$102.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $107.88 / $230.14	Professional		$75.23	$107.88	$230.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.26 / $67.70 / $126.68	Professional	26	$44.26	$67.70	$126.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.16 / $40.20 / $117.15	Professional	TC	$26.16	$40.20	$117.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.92 / $103.88 / $460.00	Professional		$71.92	$103.88	$460.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.31 / $51.00 / $299.00	Professional	26	$35.31	$51.00	$299.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.61 / $52.88 / $161.00	Professional	TC	$36.61	$52.88	$161.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.99 / $85.01 / $167.01	Professional		$63.99	$85.01	$167.01
United Facility/Professional Professional Modifier Low / Median / High Price $69.68 / $97.55 / $166.83	Professional		$69.68	$97.55	$166.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.83 / $57.20 / $88.08	Professional	26	$41.83	$57.20	$88.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $37.64 / $76.98	Professional	TC	$26.08	$37.64	$76.98