Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $134.90 / $229.09	Facility	26	$57.54	$134.90	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $251.19	Professional		$87.10	$114.82	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $162.18	Professional	26	$57.54	$70.79	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $44.67 / $89.13	Professional	TC	$30.20	$44.67	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $239.88	Professional		$95.50	$128.82	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $107.15 / $134.90	Professional	26	$70.79	$107.15	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $229.09	Professional		$95.50	$162.18	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $117.49 / $162.18	Professional	26	$64.57	$117.49	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $75.86	Professional	TC	$30.90	$47.86	$75.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $72.44 / $134.90	Professional		$44.67	$72.44	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $288.40	Professional		$102.33	$141.25	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $95.50 / $181.97	Professional	26	$69.18	$95.50	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $46.77 / $125.89	Professional	TC	$30.90	$46.77	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $602.56	Professional		$95.50	$138.04	$602.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $407.38	Professional	26	$53.70	$77.62	$407.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $177.83	Professional	TC	$41.69	$60.26	$177.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $173.78 / $208.93	Professional		$91.20	$173.78	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $218.78	Professional		$91.20	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $81.28 / $138.04	Professional	26	$58.88	$81.28	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $77.62	Professional	TC	$28.84	$40.74	$77.62