Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $105.11 / $289.76	Facility	26	$55.00	$105.11	$289.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.22 / $310.70 / $838.87	Professional		$231.22	$310.70	$838.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.00 / $179.93	Professional	26	$55.00	$83.00	$179.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.08 / $227.00 / $540.70	Professional	TC	$163.08	$227.00	$540.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.12 / $127.51 / $198.43	Professional		$86.12	$127.51	$198.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.00 / $58.27 / $102.99	Professional	26	$45.00	$58.27	$102.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.95 / $331.68 / $661.85	Professional		$199.95	$331.68	$661.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.35 / $82.54 / $166.90	Professional	26	$56.35	$82.54	$166.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.38 / $236.83 / $511.50	Professional	TC	$137.38	$236.83	$511.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $149.31 / $272.87	Professional		$60.27	$149.31	$272.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.79 / $476.75 / $833.71	Professional		$233.79	$476.75	$833.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.75 / $108.21 / $178.82	Professional	26	$62.75	$108.21	$178.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.96 / $350.70 / $639.54	Professional	TC	$164.96	$350.70	$639.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $212.29 / $385.98 / $1,104.14	Professional		$212.29	$385.98	$1,104.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.84 / $100.18 / $242.26	Professional	26	$62.84	$100.18	$242.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $149.44 / $271.70 / $1,094.51	Professional	TC	$149.44	$271.70	$1,094.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.58 / $200.37 / $347.38	Professional		$81.58	$200.37	$347.38
United Facility/Professional Professional Modifier Low / Median / High Price $227.20 / $400.64 / $696.69	Professional		$227.20	$400.64	$696.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.20 / $88.35 / $149.90	Professional	26	$63.20	$88.35	$149.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.50 / $287.61 / $490.45	Professional	TC	$158.50	$287.61	$490.45