Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $45.71 / $158.49	Facility	26	$38.02	$45.71	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $177.83	Professional		$66.07	$91.20	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $114.82	Professional	26	$38.02	$48.98	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $75.86	Professional	TC	$21.88	$38.90	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $141.25	Professional		$72.44	$93.33	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $58.88 / $77.62	Professional	26	$43.65	$58.88	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $158.49	Professional		$75.86	$114.82	$158.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $81.28 / $109.65	Professional	26	$43.65	$81.28	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $37.15 / $63.10	Professional	TC	$27.54	$37.15	$63.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $97.72	Professional		$38.02	$48.98	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $218.78	Professional		$72.44	$102.33	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.57 / $125.89	Professional	26	$47.86	$64.57	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $107.15	Professional	TC	$23.99	$37.15	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $457.09	Professional		$72.44	$104.71	$457.09
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 $34.67 / $50.12 / $154.88	Professional	TC	$34.67	$50.12	$154.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $158.49	Professional		$75.86	$123.03	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $154.88	Professional		$64.57	$89.13	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $53.70 / $95.50	Professional	26	$39.81	$53.70	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $66.07	Professional	TC	$22.91	$33.11	$66.07