Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $88.61 / $291.24	Facility	26	$55.00	$88.61	$291.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.43 / $314.01 / $804.34	Professional		$221.43	$314.01	$804.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $97.36 / $207.12	Professional	26	$55.00	$97.36	$207.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.94 / $221.81 / $467.54	Professional	TC	$132.94	$221.81	$467.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $161.60 / $336.17	Professional		$139.44	$161.60	$336.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.84 / $88.60 / $116.87	Professional	26	$50.84	$88.60	$116.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $194.37 / $204.71 / $204.71	Professional	TC	$194.37	$204.71	$204.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.90 / $295.67 / $562.37	Professional		$181.90	$295.67	$562.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.74 / $86.35 / $180.47	Professional	26	$60.74	$86.35	$180.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $119.42 / $202.66 / $397.78	Professional	TC	$119.42	$202.66	$397.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.54 / $141.82 / $237.33	Professional		$66.54	$141.82	$237.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.55 / $389.27 / $667.29	Professional		$203.55	$389.27	$667.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.51 / $107.17 / $183.95	Professional	26	$63.51	$107.17	$183.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.69 / $265.05 / $476.07	Professional	TC	$134.69	$265.05	$476.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.18 / $362.14 / $872.90	Professional		$199.18	$362.14	$872.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.25 / $110.39 / $243.50	Professional	26	$69.25	$110.39	$243.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $129.93 / $236.24 / $772.39	Professional	TC	$129.93	$236.24	$772.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.59 / $180.35 / $334.10	Professional		$92.59	$180.35	$334.10
United Facility/Professional Professional Modifier Low / Median / High Price $199.54 / $321.02 / $558.20	Professional		$199.54	$321.02	$558.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.62 / $88.72 / $155.38	Professional	26	$63.62	$88.72	$155.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.22 / $229.45 / $389.94	Professional	TC	$128.22	$229.45	$389.94