Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.36 / $42.18 / $89.94	Facility	26	$23.36	$42.18	$89.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.79 / $129.74 / $212.24	Professional		$104.79	$129.74	$212.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $26.82 / $58.87	Professional	26	$23.34	$26.82	$58.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.10 / $100.25 / $166.36	Professional	TC	$83.10	$100.25	$166.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.36 / $48.36 / $48.36	Professional	26	$48.36	$48.36	$48.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.59 / $206.09 / $404.13	Professional		$111.59	$206.09	$404.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $37.44 / $69.20	Professional	26	$23.09	$37.44	$69.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.64 / $167.80 / $342.18	Professional	TC	$79.64	$167.80	$342.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.37 / $224.10 / $413.38	Professional		$154.37	$224.10	$413.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $40.11 / $73.83	Professional	26	$26.81	$40.11	$73.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.68 / $191.85 / $356.48	Professional	TC	$123.68	$191.85	$356.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $171.70 / $234.14 / $468.58	Professional		$171.70	$234.14	$468.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.86 / $50.00 / $83.51	Professional	26	$37.86	$50.00	$83.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $133.84 / $182.51 / $394.73	Professional	TC	$133.84	$182.51	$394.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $161.76 / $280.00	Professional		$38.02	$161.76	$280.00
United Facility/Professional Professional Modifier Low / Median / High Price $159.44 / $231.49 / $387.09	Professional		$159.44	$231.49	$387.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.59 / $38.79 / $67.11	Professional	26	$26.59	$38.79	$67.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.15 / $193.62 / $350.17	Professional	TC	$135.15	$193.62	$350.17