Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $173.57 / $450.23	Facility	26	$85.00	$173.57	$450.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.92 / $475.00 / $2,085.28	Professional		$393.92	$475.00	$2,085.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $149.18 / $490.95	Professional	26	$85.00	$149.18	$490.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $291.67 / $340.00 / $931.29	Professional	TC	$291.67	$340.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.15 / $303.77 / $480.45	Professional		$224.15	$303.77	$480.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.52 / $143.85 / $188.63	Professional	26	$81.52	$143.85	$188.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $566.21 / $566.21 / $566.21	Professional	TC	$566.21	$566.21	$566.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $335.60 / $570.00 / $1,356.43	Professional		$335.60	$570.00	$1,356.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.22 / $128.47 / $270.44	Professional	26	$90.22	$128.47	$270.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.59 / $407.54 / $1,222.09	Professional	TC	$240.59	$407.54	$1,222.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $257.83 / $471.04	Professional		$103.83	$257.83	$471.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.02 / $865.73 / $1,840.84	Professional		$398.02	$865.73	$1,840.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.23 / $162.34 / $284.52	Professional	26	$98.23	$162.34	$284.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.26 / $628.05 / $1,456.65	Professional	TC	$289.26	$628.05	$1,456.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $366.67 / $666.68 / $2,781.45	Professional		$366.67	$666.68	$2,781.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.64 / $167.45 / $376.34	Professional	26	$108.64	$167.45	$376.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $258.04 / $469.16 / $2,464.77	Professional	TC	$258.04	$469.16	$2,464.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $374.18 / $623.16	Professional		$146.44	$374.18	$623.16
United Facility/Professional Professional Modifier Low / Median / High Price $382.54 / $682.06 / $1,274.58	Professional		$382.54	$682.06	$1,274.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $137.22 / $243.79	Professional	26	$97.98	$137.22	$243.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.04 / $457.90 / $1,106.89	Professional	TC	$274.04	$457.90	$1,106.89