Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.39 / $100.89 / $213.25	Facility	26	$55.39	$100.89	$213.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.45 / $154.03 / $331.47	Professional		$111.45	$154.03	$331.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.39 / $64.88 / $134.44	Professional	26	$55.39	$64.88	$134.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.43 / $61.95 / $186.00	Professional	TC	$53.43	$61.95	$186.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.16 / $200.38 / $210.19	Professional		$147.16	$200.38	$210.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $105.64 / $105.64 / $105.64	Professional	26	$105.64	$105.64	$105.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.40 / $99.40 / $99.40	Professional	TC	$99.40	$99.40	$99.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.09 / $174.56 / $356.86	Professional		$104.09	$174.56	$356.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.73 / $77.80 / $153.18	Professional	26	$51.73	$77.80	$153.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.31 / $96.57 / $195.79	Professional	TC	$51.31	$96.57	$195.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $203.16 / $346.42	Professional		$123.44	$203.16	$346.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.41 / $85.19 / $148.10	Professional	26	$60.41	$85.19	$148.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.00 / $105.65 / $192.43	Professional	TC	$60.00	$105.65	$192.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.53 / $169.82 / $435.73	Professional		$124.53	$169.82	$435.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.76 / $85.58 / $215.34	Professional	26	$62.76	$85.58	$215.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.78 / $84.24 / $435.72	Professional	TC	$61.78	$84.24	$435.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $124.53 / $331.70	Professional		$66.56	$124.53	$331.70
United Facility/Professional Professional Modifier Low / Median / High Price $123.57 / $184.23 / $319.51	Professional		$123.57	$184.23	$319.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.85 / $83.20 / $138.37	Professional	26	$62.85	$83.20	$138.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.72 / $98.54 / $176.00	Professional	TC	$60.72	$98.54	$176.00