Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.42 / $66.76 / $136.37	Facility	26	$35.42	$66.76	$136.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.55 / $219.03 / $392.09	Professional		$134.55	$219.03	$392.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $57.14 / $112.83	Professional	26	$35.42	$57.14	$112.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.13 / $130.06 / $288.85	Professional	TC	$99.13	$130.06	$288.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $240.49 / $272.35	Professional		$117.25	$240.49	$272.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.03 / $53.00 / $69.47	Professional	26	$30.03	$53.00	$69.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.02 / $217.10 / $422.15	Professional		$134.02	$217.10	$422.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $60.00 / $115.50	Professional	26	$33.09	$60.00	$115.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.20 / $160.54 / $311.88	Professional	TC	$97.20	$160.54	$311.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $117.96 / $213.14	Professional		$37.45	$117.96	$213.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.58 / $241.82 / $437.43	Professional		$160.58	$241.82	$437.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $65.56 / $111.29	Professional	26	$40.36	$65.56	$111.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.00 / $179.33 / $335.80	Professional	TC	$121.00	$179.33	$335.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.20 / $229.37 / $503.22	Professional		$168.20	$229.37	$503.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $54.56 / $140.15	Professional	26	$40.01	$54.56	$140.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $128.21 / $174.83 / $418.72	Professional	TC	$128.21	$174.83	$418.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $164.33 / $271.20	Professional		$50.95	$164.33	$271.20
United Facility/Professional Professional Modifier Low / Median / High Price $166.33 / $238.24 / $408.36	Professional		$166.33	$238.24	$408.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.75 / $64.15 / $104.77	Professional	26	$40.75	$64.15	$104.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.96 / $179.83 / $301.47	Professional	TC	$123.96	$179.83	$301.47