Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.93 / $31.93 / $59.40	Facility	26	$31.93	$31.93	$59.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $100.74 / $206.99	Professional		$64.31	$100.74	$206.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.06 / $35.10 / $68.01	Professional	26	$31.06	$35.10	$68.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $65.64 / $99.36	Professional	TC	$33.03	$65.64	$99.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.07 / $94.07 / $129.91	Professional		$94.07	$94.07	$129.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.52 / $145.38 / $145.38	Professional	26	$33.52	$145.38	$145.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.54 / $110.25 / $213.09	Professional		$62.54	$110.25	$213.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.97 / $43.08 / $80.68	Professional	26	$24.97	$43.08	$80.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $65.83 / $142.51	Professional	TC	$18.39	$65.83	$142.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $80.81 / $142.19	Professional		$38.10	$80.81	$142.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $99.56 / $216.77	Professional		$62.01	$99.56	$216.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $46.41 / $79.61	Professional	26	$33.94	$46.41	$79.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.25 / $62.02 / $144.50	Professional	TC	$23.25	$62.02	$144.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.18 / $123.04 / $335.60	Professional		$103.18	$123.04	$335.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $42.59 / $111.90	Professional	26	$36.04	$42.59	$111.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $65.51 / $85.16 / $223.72	Professional	TC	$65.51	$85.16	$223.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.69 / $94.07 / $166.20	Professional		$34.69	$94.07	$166.20
United Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $99.68 / $228.58	Professional		$67.98	$99.68	$228.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.14 / $46.76 / $80.59	Professional	26	$33.14	$46.76	$80.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $60.64 / $181.95	Professional	TC	$22.20	$60.64	$181.95