Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.45 / $47.52 / $77.44	Facility	26	$41.45	$47.52	$77.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $133.40 / $243.30	Professional		$114.43	$133.40	$243.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.51 / $45.76 / $86.63	Professional	26	$40.51	$45.76	$86.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.30 / $84.93 / $153.26	Professional	TC	$71.30	$84.93	$153.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.49 / $211.91 / $218.01	Professional		$109.49	$211.91	$218.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.83 / $54.83 / $54.83	Professional	26	$54.83	$54.83	$54.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $138.38 / $295.87	Professional		$85.60	$138.38	$295.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.27 / $53.35 / $106.27	Professional	26	$32.27	$53.35	$106.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.73 / $87.50 / $198.84	Professional	TC	$53.73	$87.50	$198.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.69 / $177.08 / $295.45	Professional		$111.69	$177.08	$295.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.02 / $62.14 / $103.28	Professional	26	$46.02	$62.14	$103.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.90 / $111.12 / $209.91	Professional	TC	$68.90	$111.12	$209.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.55 / $148.38 / $389.82	Professional		$125.55	$148.38	$389.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.75 / $55.25 / $145.18	Professional	26	$46.75	$55.25	$145.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $78.80 / $93.13 / $244.64	Professional	TC	$78.80	$93.13	$244.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $107.46 / $199.58	Professional		$45.34	$107.46	$199.58
United Facility/Professional Professional Modifier Low / Median / High Price $117.08 / $166.68 / $276.83	Professional		$117.08	$166.68	$276.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.08 / $65.59 / $113.60	Professional	26	$44.08	$65.59	$113.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.92 / $112.19 / $202.65	Professional	TC	$72.92	$112.19	$202.65