Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $97.72 / $158.49	Facility	26	$38.90	$97.72	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $199.53	Professional		$70.79	$89.13	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $114.82	Professional	26	$38.02	$50.12	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $83.18	Professional	TC	$26.30	$42.66	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $162.18	Professional		$85.11	$114.82	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $79.43 / $93.33	Professional	26	$75.86	$79.43	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	TC	$77.62	$77.62	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $173.78	Professional		$81.28	$120.23	$173.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $81.28 / $114.82	Professional	26	$45.71	$81.28	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $40.74 / $70.79	Professional	TC	$29.51	$40.74	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $229.09	Professional		$77.62	$107.15	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $125.89	Professional	26	$47.86	$67.61	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $117.49	Professional	TC	$26.92	$41.69	$117.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $478.63	Professional		$75.86	$109.65	$478.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $275.42	Professional	26	$37.15	$53.70	$275.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $56.23 / $165.96	Professional	TC	$38.90	$56.23	$165.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $165.96	Professional		$79.43	$131.83	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $165.96	Professional		$69.18	$95.50	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $95.50	Professional	26	$40.74	$56.23	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $74.13	Professional	TC	$25.70	$37.15	$74.13