Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.96 / $28.80 / $64.86	Facility	26	$25.96	$28.80	$64.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.48 / $62.68 / $128.86	Professional		$51.48	$62.68	$128.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.91 / $29.10 / $63.82	Professional	26	$24.91	$29.10	$63.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.34 / $33.03 / $66.22	Professional	TC	$26.34	$33.03	$66.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.13 / $73.00 / $119.52	Professional		$59.13	$73.00	$119.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.34 / $46.24	Professional	26	$25.12	$38.34	$46.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $86.65 / $172.79	Professional		$56.89	$86.65	$172.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.05 / $41.37 / $69.95	Professional	26	$26.05	$41.37	$69.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.52 / $44.99 / $101.86	Professional	TC	$30.52	$44.99	$101.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $24.98 / $24.98	Professional		$24.98	$24.98	$24.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.10 / $84.59 / $167.28	Professional		$60.10	$84.59	$167.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.68 / $39.90 / $68.67	Professional	26	$28.68	$39.90	$68.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.07 / $44.18 / $95.21	Professional	TC	$31.07	$44.18	$95.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $79.95 / $214.93	Professional		$61.50	$79.95	$214.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $34.15 / $83.82	Professional	26	$26.27	$34.15	$83.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.24 / $45.81 / $214.93	Professional	TC	$35.24	$45.81	$214.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $49.34 / $100.35	Professional		$28.16	$49.34	$100.35
United Facility/Professional Professional Modifier Low / Median / High Price $54.17 / $76.09 / $126.86	Professional		$54.17	$76.09	$126.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.90 / $35.97 / $57.56	Professional	26	$25.90	$35.97	$57.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.82 / $38.35 / $64.26	Professional	TC	$26.82	$38.35	$64.26