Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $163.06 / $313.52	Facility	26	$85.00	$163.06	$313.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.71 / $475.00 / $1,156.33	Professional		$362.71	$475.00	$1,156.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.53 / $111.36 / $260.45	Professional	26	$69.53	$111.36	$260.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.27 / $340.00 / $985.40	Professional	TC	$288.27	$340.00	$985.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.52 / $302.95 / $556.40	Professional		$289.52	$302.95	$556.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.85 / $98.34 / $128.96	Professional	26	$53.85	$98.34	$128.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.33 / $590.55 / $1,386.11	Professional		$326.33	$590.55	$1,386.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.79 / $95.63 / $197.12	Professional	26	$64.79	$95.63	$197.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $259.30 / $463.06 / $1,234.48	Professional	TC	$259.30	$463.06	$1,234.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.26 / $281.66 / $465.33	Professional		$71.26	$281.66	$465.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.15 / $909.30 / $1,879.54	Professional		$423.15	$909.30	$1,879.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.95 / $127.87 / $227.25	Professional	26	$73.95	$127.87	$227.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $334.47 / $794.16 / $1,563.20	Professional	TC	$334.47	$794.16	$1,563.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $356.83 / $648.78 / $2,467.23	Professional		$356.83	$648.78	$2,467.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.27 / $129.37 / $316.07	Professional	26	$74.27	$129.37	$316.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $282.57 / $513.76 / $2,466.64	Professional	TC	$282.57	$513.76	$2,466.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.43 / $373.09 / $600.12	Professional		$96.43	$373.09	$600.12
United Facility/Professional Professional Modifier Low / Median / High Price $350.48 / $772.83 / $1,484.75	Professional		$350.48	$772.83	$1,484.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.02 / $101.57 / $176.92	Professional	26	$74.02	$101.57	$176.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $565.90 / $1,070.55	Professional	TC	$281.41	$565.90	$1,070.55