Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $42.66 / $72.44	Facility	26	$30.90	$42.66	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $257.04	Professional		$69.18	$102.33	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $34.67 / $107.15	Professional	26	$29.51	$34.67	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $67.61 / $104.71	Professional	TC	$33.88	$67.61	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $93.33 / $208.93	Professional		$81.28	$93.33	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.11 / $34.67	Professional	26	$31.62	$33.11	$34.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $79.43 / $162.18	Professional		$51.29	$79.43	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $64.57	Professional	26	$31.62	$44.67	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $37.15 / $102.33	Professional	TC	$14.79	$37.15	$102.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $81.28 / $134.90	Professional		$40.74	$81.28	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $257.04	Professional		$67.61	$107.15	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $47.86 / $81.28	Professional	26	$35.48	$47.86	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $64.57 / $154.88	Professional	TC	$23.44	$64.57	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $338.84	Professional		$107.15	$128.82	$338.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $44.67 / $125.89	Professional	26	$36.31	$44.67	$125.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $91.20 / $223.87	Professional	TC	$74.13	$91.20	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $100.00 / $194.98	Professional		$38.02	$100.00	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $100.00 / $213.80	Professional		$61.66	$100.00	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $81.28	Professional	26	$33.11	$46.77	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $60.26 / $147.91	Professional	TC	$22.39	$60.26	$147.91