Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.01 / $75.02 / $136.72	Facility	26	$75.01	$75.02	$136.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $160.86 / $264.30	Professional		$130.08	$160.86	$264.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.72 / $82.39 / $185.52	Professional	26	$72.72	$82.39	$185.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.39 / $80.56 / $130.10	Professional	TC	$51.39	$80.56	$130.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $149.44 / $149.44	Professional		$149.44	$149.44	$149.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.31 / $114.68 / $137.37	Professional	26	$84.31	$114.68	$137.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.57 / $178.45 / $362.37	Professional		$109.57	$178.45	$362.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.61 / $103.16 / $182.28	Professional	26	$58.61	$103.16	$182.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.47 / $89.36 / $177.14	Professional	TC	$38.47	$89.36	$177.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.41 / $109.25 / $219.63	Professional		$77.41	$109.25	$219.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $194.42 / $360.48	Professional		$113.15	$194.42	$360.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.42 / $110.64 / $194.88	Professional	26	$80.42	$110.64	$194.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.58 / $103.90 / $187.58	Professional	TC	$42.58	$103.90	$187.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.38 / $194.27 / $510.38	Professional		$164.38	$194.27	$510.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.51 / $99.88 / $262.42	Professional	26	$84.51	$99.88	$262.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.23 / $94.38 / $314.54	Professional	TC	$76.23	$94.38	$314.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.44 / $131.09 / $266.70	Professional		$76.44	$131.09	$266.70
United Facility/Professional Professional Modifier Low / Median / High Price $140.61 / $190.53 / $356.15	Professional		$140.61	$190.53	$356.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.01 / $111.49 / $187.82	Professional	26	$79.01	$111.49	$187.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.46 / $96.67 / $176.11	Professional	TC	$45.46	$96.67	$176.11