Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.08 / $42.08 / $76.23	Facility	26	$42.08	$42.08	$76.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $113.21 / $341.00	Professional		$84.00	$113.21	$341.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.08 / $48.88 / $100.74	Professional	26	$42.08	$48.88	$100.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.00 / $198.22 / $369.54	Professional	50	$147.00	$198.22	$369.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.17 / $52.89 / $106.15	Professional	TC	$40.17	$52.89	$106.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $125.19 / $171.50	Professional		$83.72	$125.19	$171.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.08 / $64.30 / $79.23	Professional	26	$52.08	$64.30	$79.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $142.55 / $240.30 / $240.30	Professional	50	$142.55	$240.30	$240.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.67 / $117.61 / $196.88	Professional		$70.67	$117.61	$196.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $60.50 / $97.49	Professional	26	$34.86	$60.50	$97.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.65 / $58.06 / $106.79	Professional	TC	$35.65	$58.06	$106.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.37 / $66.72 / $132.62	Professional		$47.37	$66.72	$132.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.52 / $117.79 / $216.69	Professional		$88.52	$117.79	$216.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $64.19 / $118.43	Professional	26	$46.77	$64.19	$118.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.20 / $61.12 / $115.20	Professional	TC	$44.20	$61.12	$115.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $99.56 / $117.66 / $428.00	Professional		$99.56	$117.66	$428.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.41 / $56.03 / $231.12	Professional	26	$47.41	$56.03	$231.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.15 / $61.63 / $196.88	Professional	TC	$52.15	$61.63	$196.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $79.56 / $157.10	Professional		$45.13	$79.56	$157.10
United Facility/Professional Professional Modifier Low / Median / High Price $91.40 / $132.72 / $248.81	Professional		$91.40	$132.72	$248.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.68 / $66.14 / $112.65	Professional	26	$43.68	$66.14	$112.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.09 / $63.14 / $153.43	Professional	TC	$44.09	$63.14	$153.43