Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.05 / $29.87 / $84.93	Facility	26	$22.05	$29.87	$84.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.56 / $140.41 / $303.87	Professional		$109.56	$140.41	$303.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.12 / $25.98 / $56.13	Professional	26	$16.12	$25.98	$56.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.54 / $109.29 / $241.24	Professional	TC	$97.54	$109.29	$241.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $160.35 / $219.71	Professional		$72.20	$160.35	$219.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.72 / $35.31 / $41.12	Professional	26	$17.72	$35.31	$41.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $165.74 / $332.54	Professional		$106.50	$165.74	$332.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $25.98 / $50.36	Professional	26	$16.07	$25.98	$50.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.57 / $136.90 / $279.01	Professional	TC	$86.57	$136.90	$279.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $43.35	Facility	26	$26.70	$26.70	$43.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.12 / $180.27 / $327.84	Professional		$123.12	$180.27	$327.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.43 / $31.04 / $50.97	Professional	26	$17.43	$31.04	$50.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.24 / $159.16 / $281.83	Professional	TC	$101.24	$159.16	$281.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $177.51 / $376.92	Professional		$130.16	$177.51	$376.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.37 / $31.01 / $64.37	Professional	26	$24.37	$31.01	$64.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $105.81 / $144.29 / $340.49	Professional	TC	$105.81	$144.29	$340.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.01 / $123.64 / $218.93	Professional		$31.01	$123.64	$218.93
United Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $196.02 / $320.69	Professional		$131.13	$196.02	$320.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $27.76 / $60.18	Professional	26	$18.89	$27.76	$60.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.62 / $156.12 / $260.51	Professional	TC	$105.62	$156.12	$260.51