Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.67 / $91.12 / $252.60	Facility	26	$83.67	$91.12	$252.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $872.73	Professional		$250.00	$425.00	$872.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.68 / $99.35 / $176.72	Professional	26	$69.68	$99.35	$176.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.95 / $340.00 / $753.53	Professional	TC	$192.95	$340.00	$753.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.52 / $189.22 / $393.62	Professional		$162.52	$189.22	$393.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $76.73 / $104.11	Professional	26	$41.94	$76.73	$104.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.24 / $425.00 / $775.04	Professional		$213.24	$425.00	$775.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.11 / $73.98 / $152.57	Professional	26	$54.11	$73.98	$152.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $159.13 / $308.77 / $679.15	Professional	TC	$159.13	$308.77	$679.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $173.09 / $316.52	Professional		$57.66	$173.09	$316.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.30 / $570.03 / $1,057.94	Professional		$279.30	$570.03	$1,057.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.20 / $96.11 / $170.61	Professional	26	$55.20	$96.11	$170.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.70 / $465.45 / $940.37	Professional	TC	$224.70	$465.45	$940.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $233.21 / $424.02 / $1,556.72	Professional		$233.21	$424.02	$1,556.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.96 / $93.32 / $211.53	Professional	26	$59.96	$93.32	$211.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $173.25 / $315.00 / $1,397.42	Professional	TC	$173.25	$315.00	$1,397.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.29 / $234.52 / $392.96	Professional		$78.29	$234.52	$392.96
United Facility/Professional Professional Modifier Low / Median / High Price $223.74 / $448.24 / $781.61	Professional		$223.74	$448.24	$781.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.63 / $76.59 / $130.66	Professional	26	$54.63	$76.59	$130.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.90 / $351.30 / $671.84	Professional	TC	$168.90	$351.30	$671.84