Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $151.36 / $331.13	Facility	26	$85.11	$151.36	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $1,288.25	Professional		$331.13	$478.63	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $125.89 / $295.12	Professional	26	$67.61	$125.89	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $812.83	Professional	TC	$257.04	$338.84	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $426.58	Professional		$223.87	$223.87	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $100.00 / $128.82	Professional	26	$61.66	$100.00	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $676.08 / $1,412.54	Professional		$380.19	$676.08	$1,412.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $109.65 / $173.78	Professional	26	$58.88	$109.65	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $549.54 / $1,258.93	Professional	TC	$316.23	$549.54	$1,258.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $263.03 / $407.38	Professional		$70.79	$263.03	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $851.14 / $1,659.59	Professional		$398.11	$851.14	$1,659.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $120.23 / $213.80	Professional	26	$69.18	$120.23	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $660.69 / $1,479.11	Professional	TC	$331.13	$660.69	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $436.52 / $2,454.71	Professional		$331.13	$436.52	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $245.47	Professional	26	$69.18	$93.33	$245.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $346.74 / $2,454.71	Professional	TC	$263.03	$346.74	$2,454.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $288.40 / $588.84	Professional		$70.79	$288.40	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $691.83 / $1,288.25	Professional		$338.84	$691.83	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $95.50 / $169.82	Professional	26	$70.79	$95.50	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $537.03 / $1,071.52	Professional	TC	$269.15	$537.03	$1,071.52