Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.00 / $103.80 / $219.45	Facility	26	$57.00	$103.80	$219.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.03 / $106.01 / $211.12	Professional		$86.03	$106.01	$211.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.25 / $62.96 / $124.67	Professional	26	$56.25	$62.96	$124.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.51 / $42.81 / $89.04	Professional	TC	$30.51	$42.81	$89.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.24 / $128.16 / $239.62	Professional		$94.24	$128.16	$239.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.69 / $103.75 / $110.19	Professional	26	$57.69	$103.75	$110.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.85 / $146.35 / $263.27	Professional		$90.85	$146.35	$263.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.92 / $101.05 / $171.81	Professional	26	$51.92	$101.05	$171.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.68 / $50.52 / $108.79	Professional	TC	$31.68	$50.52	$108.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $69.59 / $124.45	Professional		$45.02	$69.59	$124.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.39 / $140.44 / $290.74	Professional		$97.39	$140.44	$290.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.77 / $95.35 / $181.62	Professional	26	$64.77	$95.35	$181.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.02 / $46.21 / $124.58	Professional	TC	$30.02	$46.21	$124.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.86 / $131.24 / $576.00	Professional		$90.86	$131.24	$576.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.92 / $75.00 / $403.20	Professional	26	$51.92	$75.00	$403.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.93 / $56.24 / $172.80	Professional	TC	$38.93	$56.24	$172.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $119.06 / $210.83	Professional		$69.09	$119.06	$210.83
United Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $125.74 / $206.89	Professional		$91.16	$125.74	$206.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $84.69 / $128.58	Professional	26	$61.68	$84.69	$128.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.16 / $41.10 / $70.68	Professional	TC	$29.16	$41.10	$70.68