Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $91.98 / $325.33	Facility	26	$55.00	$91.98	$325.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.70 / $292.33 / $878.92	Professional		$168.70	$292.33	$878.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.50 / $210.00	Professional	26	$51.30	$60.50	$210.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $220.00 / $531.29	Professional	TC	$119.70	$220.00	$531.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.54 / $126.32 / $278.55	Professional		$76.54	$126.32	$278.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $61.95 / $98.59	Professional	26	$38.72	$61.95	$98.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.57 / $192.09 / $192.09	Professional	TC	$51.57	$192.09	$192.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.96 / $284.35 / $556.54	Professional		$166.96	$284.35	$556.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.83 / $77.23 / $155.38	Professional	26	$52.83	$77.23	$155.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.39 / $198.56 / $412.92	Professional	TC	$112.39	$198.56	$412.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $122.01 / $223.09	Professional		$56.24	$122.01	$223.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.24 / $63.24 / $63.24	Facility	26	$63.24	$63.24	$63.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.10 / $402.17 / $683.30	Professional		$197.10	$402.17	$683.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $98.40 / $177.45	Professional	26	$56.69	$98.40	$177.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.06 / $282.50 / $517.29	Professional	TC	$135.06	$282.50	$517.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.66 / $328.48 / $895.67	Professional		$180.66	$328.48	$895.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $93.31 / $251.50	Professional	26	$58.53	$93.31	$251.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $122.12 / $222.04 / $895.67	Professional	TC	$122.12	$222.04	$895.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.41 / $167.30 / $295.63	Professional		$76.41	$167.30	$295.63
United Facility/Professional Professional Modifier Low / Median / High Price $193.34 / $325.91 / $584.42	Professional		$193.34	$325.91	$584.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.77 / $79.33 / $136.06	Professional	26	$55.77	$79.33	$136.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.80 / $236.39 / $491.00	Professional	TC	$121.80	$236.39	$491.00