Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.28 / $28.82 / $44.29	Facility	26	$26.28	$28.82	$44.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.62 / $53.61 / $197.60	Professional		$44.62	$53.61	$197.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $29.94 / $69.97	Professional	26	$23.37	$29.94	$69.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.65 / $38.65 / $38.65	Professional	52	$38.65	$38.65	$38.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.92 / $23.83 / $64.45	Professional	TC	$19.92	$23.83	$64.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $38.15 / $68.88	Professional		$33.45	$38.15	$68.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.04 / $40.17 / $51.24	Professional	26	$25.04	$40.17	$51.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.40 / $62.21 / $110.78	Professional		$44.40	$62.21	$110.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.05 / $36.76 / $75.86	Professional	26	$27.05	$36.76	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $28.03 / $48.67	Professional	TC	$18.55	$28.03	$48.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.16 / $33.04 / $62.23	Professional		$15.16	$33.04	$62.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $90.64	Professional		$39.28	$39.28	$90.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $58.51	Professional	26	$25.29	$25.29	$58.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $32.13	Professional	TC	$13.99	$13.99	$32.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $74.78 / $262.00	Professional		$42.75	$74.78	$262.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $33.11 / $246.05	Professional	26	$26.78	$33.11	$246.05
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $26.17 / $26.17 / $29.27	Professional	52	$26.17	$26.17	$29.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $13.42 / $18.19 / $209.46	Professional	TC	$13.42	$18.19	$209.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $40.22 / $75.83	Professional		$18.70	$40.22	$75.83
United Facility/Professional Professional Modifier Low / Median / High Price $52.20 / $74.59 / $119.07	Professional		$52.20	$74.59	$119.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.13 / $41.68 / $67.00	Professional	26	$29.13	$41.68	$67.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $32.77 / $51.67	Professional	TC	$22.21	$32.77	$51.67