Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.66 / $30.66 / $35.35	Facility	26	$30.66	$30.66	$35.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $90.46 / $132.83	Professional		$79.77	$90.46	$132.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.54 / $31.89 / $42.12	Professional	26	$28.54	$31.89	$42.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.31 / $135.94 / $218.37	Professional		$83.31	$135.94	$218.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.69 / $47.91 / $80.48	Professional	26	$29.69	$47.91	$80.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.63 / $28.63 / $28.63	Professional		$28.63	$28.63	$28.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.04 / $36.04 / $36.04	Facility	26	$36.04	$36.04	$36.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $127.45 / $222.10	Professional		$93.45	$127.45	$222.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $46.20 / $79.53	Professional	26	$34.02	$46.20	$79.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.67 / $111.31 / $279.27	Professional		$86.67	$111.31	$279.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.10 / $36.11 / $69.23	Professional	26	$30.10	$36.11	$69.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $71.56 / $135.22	Professional		$32.04	$71.56	$135.22
United Facility/Professional Professional Modifier Low / Median / High Price $83.41 / $120.14 / $192.98	Professional		$83.41	$120.14	$192.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.86 / $42.60 / $67.02	Professional	26	$30.86	$42.60	$67.02