Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $56.23 / $74.13	Facility	26	$40.74	$56.23	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $169.82	Professional		$75.86	$89.13	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $87.10	Professional	26	$38.90	$45.71	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $41.69 / $81.28	Professional	TC	$33.11	$41.69	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $158.49	Professional		$66.07	$83.18	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $147.91	Professional		$63.10	$85.11	$147.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $52.48 / $85.11	Professional	26	$38.90	$52.48	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $38.02 / $69.18	Professional	TC	$16.60	$38.02	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $194.98	Professional		$75.86	$109.65	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $63.10 / $107.15	Professional	26	$45.71	$63.10	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $52.48 / $102.33	Professional	TC	$28.84	$52.48	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $309.03	Professional		$95.50	$120.23	$309.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $57.54 / $165.96	Professional	26	$46.77	$57.54	$165.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $61.66 / $144.54	Professional	TC	$46.77	$61.66	$144.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $169.82	Professional		$45.71	$85.11	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $194.98	Professional		$74.13	$100.00	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $107.15	Professional	26	$42.66	$60.26	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $44.67 / $97.72	Professional	TC	$25.70	$44.67	$97.72