Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.15 / $73.15 / $133.71	Facility	26	$73.15	$73.15	$133.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.16 / $153.71 / $302.94	Professional		$128.16	$153.71	$302.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $80.73 / $155.84	Professional	26	$72.04	$80.73	$155.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.95 / $61.75 / $120.67	Professional	TC	$53.95	$61.75	$120.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.93 / $202.68 / $239.66	Professional		$121.93	$202.68	$239.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.81 / $134.29 / $143.59	Professional	26	$90.81	$134.29	$143.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.42 / $167.16 / $287.22	Professional		$100.42	$167.16	$287.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $91.11 / $160.52	Professional	26	$57.10	$91.11	$160.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.68 / $71.45 / $128.43	Professional	TC	$44.68	$71.45	$128.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $101.29 / $189.86	Professional		$58.88	$101.29	$189.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $182.96 / $312.08	Professional		$109.65	$182.96	$312.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.88 / $108.56 / $182.68	Professional	26	$81.88	$108.56	$182.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.84 / $84.50 / $141.94	Professional	TC	$62.84	$84.50	$141.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.27 / $166.96 / $939.08	Professional		$141.27	$166.96	$939.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $97.73 / $517.65	Professional	26	$82.70	$97.73	$517.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.58 / $69.23 / $421.43	Professional	TC	$58.58	$69.23	$421.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $116.25 / $229.20	Professional		$61.49	$116.25	$229.20
United Facility/Professional Professional Modifier Low / Median / High Price $133.82 / $207.89 / $342.64	Professional		$133.82	$207.89	$342.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.23 / $115.65 / $191.13	Professional	26	$77.23	$115.65	$191.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.87 / $86.68 / $146.63	Professional	TC	$57.87	$86.68	$146.63