Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.36 / $41.54 / $136.13	Facility	26	$35.36	$41.54	$136.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.79 / $239.41 / $513.60	Professional		$174.79	$239.41	$513.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.56 / $41.55 / $106.22	Professional	26	$34.56	$41.55	$106.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.36 / $174.54 / $347.50	Professional	TC	$141.36	$174.54	$347.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.61 / $238.16 / $337.34	Professional		$139.61	$238.16	$337.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $53.24 / $67.79	Professional	26	$30.21	$53.24	$67.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $173.83 / $239.06 / $257.08	Professional	TC	$173.83	$239.06	$257.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.53 / $253.76 / $507.91	Professional		$163.53	$253.76	$507.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.47 / $43.61 / $81.64	Professional	26	$30.47	$43.61	$81.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.72 / $207.42 / $416.98	Professional	TC	$130.72	$207.42	$416.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $147.16 / $252.53	Professional		$37.47	$147.16	$252.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $70.54	Facility	26	$43.27	$43.27	$70.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.15 / $287.56 / $510.25	Professional		$191.15	$287.56	$510.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.69 / $51.48 / $96.43	Professional	26	$32.69	$51.48	$96.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.26 / $239.90 / $425.58	Professional	TC	$155.26	$239.90	$425.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.87 / $272.55 / $588.04	Professional		$199.87	$272.55	$588.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.10 / $51.03 / $154.34	Professional	26	$40.10	$51.03	$154.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.78 / $217.88 / $502.04	Professional	TC	$159.78	$217.88	$502.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.81 / $188.89 / $320.69	Professional		$43.81	$188.89	$320.69
United Facility/Professional Professional Modifier Low / Median / High Price $201.40 / $284.47 / $473.80	Professional		$201.40	$284.47	$473.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.20 / $50.66 / $81.16	Professional	26	$34.20	$50.66	$81.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.25 / $237.21 / $403.81	Professional	TC	$159.25	$237.21	$403.81