Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.11 / $41.92 / $88.97	Facility	26	$23.11	$41.92	$88.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.09 / $120.82 / $275.27	Professional		$90.09	$120.82	$275.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.01 / $28.45 / $77.93	Professional	26	$23.01	$28.45	$77.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.31 / $82.79 / $181.42	Professional	TC	$70.31	$82.79	$181.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $159.15 / $175.24	Professional		$80.23	$159.15	$175.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $43.96 / $55.83	Professional	26	$30.51	$43.96	$55.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.39 / $156.32 / $306.52	Professional		$94.39	$156.32	$306.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.49 / $41.28 / $78.34	Professional	26	$23.49	$41.28	$78.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.70 / $117.64 / $228.23	Professional	TC	$70.70	$117.64	$228.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.44 / $71.53 / $131.79	Professional		$24.44	$71.53	$131.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $45.03	Facility	26	$28.20	$28.20	$45.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.78 / $158.12 / $282.99	Professional		$105.78	$158.12	$282.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.24 / $40.64 / $68.19	Professional	26	$28.24	$40.64	$68.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.45 / $119.19 / $226.10	Professional	TC	$78.45	$119.19	$226.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $141.59 / $362.41	Professional		$103.83	$141.59	$362.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.05 / $35.52 / $83.83	Professional	26	$26.05	$35.52	$83.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.78 / $105.00 / $287.76	Professional	TC	$77.78	$105.00	$287.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $123.04 / $187.40	Professional		$37.97	$123.04	$187.40
United Facility/Professional Professional Modifier Low / Median / High Price $99.69 / $142.75 / $280.77	Professional		$99.69	$142.75	$280.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $34.76 / $62.98	Professional	26	$25.82	$34.76	$62.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.04 / $104.76 / $187.14	Professional	TC	$74.04	$104.76	$187.14