Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $134.90 / $398.11	Facility	26	$54.95	$134.90	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $363.08 / $1,202.26	Professional		$257.04	$363.08	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $91.20 / $288.40	Professional	26	$70.79	$91.20	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $251.19 / $562.34	Professional	TC	$162.18	$251.19	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $489.78	Professional		$199.53	$257.04	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $144.54	Professional	26	$64.57	$81.28	$144.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $165.96 / $257.04	Professional	TC	$141.25	$165.96	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $870.96	Professional		$251.19	$398.11	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $117.49 / $181.97	Professional	26	$61.66	$117.49	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $316.23 / $707.95	Professional	TC	$199.53	$316.23	$707.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $213.80 / $354.81	Professional		$89.13	$213.80	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $537.03 / $1,000.00	Professional		$281.84	$537.03	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $131.83 / $234.42	Professional	26	$79.43	$131.83	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $398.11 / $741.31	Professional	TC	$194.98	$398.11	$741.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $371.54 / $1,513.56	Professional		$288.40	$371.54	$1,513.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $114.82 / $371.54	Professional	26	$85.11	$114.82	$371.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $263.03 / $1,513.56	Professional	TC	$199.53	$263.03	$1,513.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $257.04 / $467.74	Professional		$87.10	$257.04	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $489.78 / $851.14	Professional		$281.84	$489.78	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $204.17	Professional	26	$83.18	$112.20	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $346.74 / $630.96	Professional	TC	$194.98	$346.74	$630.96