Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $70.95 / $149.80	Facility	26	$38.90	$70.95	$149.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $80.72 / $156.54	Professional		$61.30	$80.72	$156.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $44.48 / $85.20	Professional	26	$37.95	$44.48	$85.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $36.07 / $71.43	Professional	TC	$23.28	$36.07	$71.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $134.59 / $180.85	Professional		$72.06	$134.59	$180.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $70.56 / $91.76	Professional	26	$41.81	$70.56	$91.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $107.52 / $190.96	Professional		$64.45	$107.52	$190.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.29 / $67.95 / $114.44	Professional	26	$35.29	$67.95	$114.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.76 / $42.22 / $92.92	Professional	TC	$26.76	$42.22	$92.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.74 / $47.26 / $93.16	Professional		$37.74	$47.26	$93.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $100.24 / $218.99	Professional		$70.48	$100.24	$218.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.92 / $63.91 / $126.68	Professional	26	$43.92	$63.91	$126.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.97 / $36.06 / $106.00	Professional	TC	$22.97	$36.06	$106.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $98.85 / $439.00	Professional		$68.44	$98.85	$439.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.31 / $51.00 / $289.74	Professional	26	$35.31	$51.00	$289.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.13 / $47.85 / $149.26	Professional	TC	$33.13	$47.85	$149.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $80.73 / $158.91	Professional		$58.84	$80.73	$158.91
United Facility/Professional Professional Modifier Low / Median / High Price $64.30 / $90.86 / $144.68	Professional		$64.30	$90.86	$144.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.51 / $57.20 / $87.35	Professional	26	$40.51	$57.20	$87.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $32.83 / $58.84	Professional	TC	$23.48	$32.83	$58.84