Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $38.90 / $144.54	Facility	26	$35.48	$38.90	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $562.34	Professional		$169.82	$263.03	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $112.20	Professional	26	$34.67	$45.71	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $363.08	Professional	TC	$141.25	$181.97	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $302.00	Professional		$128.82	$173.78	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $67.61	Professional	26	$30.20	$39.81	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $141.25 / $257.04	Professional	TC	$107.15	$141.25	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $436.52	Professional		$190.55	$275.42	$436.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $75.86	Professional	26	$30.90	$44.67	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $229.09 / $354.81	Professional	TC	$162.18	$229.09	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $154.88 / $229.09	Professional		$38.02	$154.88	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $512.86	Professional		$181.97	$275.42	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $87.10	Professional	26	$32.36	$47.86	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $234.42 / $416.87	Professional	TC	$151.36	$234.42	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $616.60	Professional		$190.55	$251.19	$616.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $154.88	Professional	26	$38.02	$48.98	$154.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $501.19	Professional	TC	$154.88	$199.53	$501.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $177.83 / $380.19	Professional		$40.74	$177.83	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $457.09	Professional		$190.55	$269.15	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $77.62	Professional	26	$33.11	$44.67	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $223.87 / $389.05	Professional	TC	$151.36	$223.87	$389.05