Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.24 / $93.55 / $201.12	Facility	26	$52.24	$93.55	$201.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.75 / $99.30 / $187.73	Professional		$74.75	$99.30	$187.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.17 / $59.82 / $114.82	Professional	26	$51.17	$59.82	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $39.44 / $78.37	Professional	TC	$26.89	$39.44	$78.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $117.84 / $178.62	Professional		$87.29	$117.84	$178.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.66 / $93.58 / $98.72	Professional	26	$56.66	$93.58	$98.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.16 / $134.47 / $234.50	Professional		$84.16	$134.47	$234.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $91.48 / $153.83	Professional	26	$47.85	$91.48	$153.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.28 / $46.13 / $101.65	Professional	TC	$29.28	$46.13	$101.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.01 / $64.06 / $115.27	Professional		$42.01	$64.06	$115.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $125.59 / $269.35	Professional		$89.93	$125.59	$269.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.51 / $84.81 / $167.25	Professional	26	$59.51	$84.81	$167.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $40.32 / $116.22	Professional	TC	$26.96	$40.32	$116.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.17 / $121.58 / $534.00	Professional		$84.17	$121.58	$534.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $69.12 / $363.12	Professional	26	$47.85	$69.12	$363.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.32 / $52.46 / $170.88	Professional	TC	$36.32	$52.46	$170.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.56 / $109.67 / $195.42	Professional		$64.56	$109.67	$195.42
United Facility/Professional Professional Modifier Low / Median / High Price $82.97 / $112.46 / $179.94	Professional		$82.97	$112.46	$179.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.88 / $77.83 / $113.75	Professional	26	$56.88	$77.83	$113.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.48 / $37.13 / $63.32	Professional	TC	$26.48	$37.13	$63.32