Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $36.31 / $93.33	Facility	26	$22.91	$36.31	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $162.18 / $416.87	Professional		$91.20	$162.18	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $109.65	Professional	26	$22.91	$36.31	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $87.10 / $177.83	Professional	TC	$67.61	$87.10	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $173.78	Professional		$72.44	$102.33	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.90 / $47.86	Professional	26	$19.50	$30.90	$47.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	TC	$89.13	$89.13	$89.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $251.19	Professional		$107.15	$173.78	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $46.77 / $67.61	Professional	26	$27.54	$46.77	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $131.83 / $186.21	Professional	TC	$79.43	$131.83	$186.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $74.13 / $120.23	Professional		$25.12	$74.13	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $251.19	Professional		$102.33	$147.91	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.02 / $66.07	Professional	26	$26.92	$38.02	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $190.55	Professional	TC	$77.62	$112.20	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $380.19	Professional		$102.33	$134.90	$380.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.88 / $83.18	Professional	26	$25.12	$33.88	$83.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $102.33 / $302.00	Professional	TC	$77.62	$102.33	$302.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $147.91 / $223.87	Professional		$46.77	$147.91	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $239.88	Professional		$95.50	$134.90	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $63.10	Professional	26	$24.55	$33.88	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $100.00 / $181.97	Professional	TC	$69.18	$100.00	$181.97