Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.25 / $17.25 / $30.96	Facility	26	$17.25	$17.25	$30.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.20 / $72.51 / $159.19	Professional		$56.20	$72.51	$159.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.99 / $19.88 / $44.21	Professional	26	$15.99	$19.88	$44.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.21 / $50.75 / $111.80	Professional	TC	$40.21	$50.75	$111.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $77.04 / $99.45	Professional		$68.20	$77.04	$99.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.35 / $29.01 / $35.90	Professional	26	$19.35	$29.01	$35.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $86.20 / $188.61	Professional		$58.42	$86.20	$188.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.10 / $22.99 / $47.69	Professional	26	$18.10	$22.99	$47.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.92 / $63.21 / $128.30	Professional	TC	$47.92	$63.21	$128.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $51.52 / $151.84	Professional		$20.14	$51.52	$151.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $145.28	Professional		$67.55	$67.55	$145.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $39.83	Professional	26	$18.45	$18.45	$39.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $105.44	Professional	TC	$49.10	$49.10	$105.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.37 / $95.38 / $270.00	Professional		$73.37	$95.38	$270.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.12 / $24.14 / $40.24	Professional	26	$20.12	$24.14	$40.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $53.25 / $63.90 / $106.50	Professional	TC	$53.25	$63.90	$106.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $75.13 / $121.79	Professional		$26.25	$75.13	$121.79
United Facility/Professional Professional Modifier Low / Median / High Price $73.13 / $110.90 / $195.70	Professional		$73.13	$110.90	$195.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.88 / $24.44 / $46.65	Professional	26	$17.88	$24.44	$46.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $87.43 / $144.71	Professional	TC	$50.89	$87.43	$144.71