Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $109.87 / $383.37	Facility	26	$55.00	$109.87	$383.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $351.89 / $1,196.94	Professional		$275.00	$351.89	$1,196.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $88.09 / $284.08	Professional	26	$55.00	$88.09	$284.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $309.93 / $881.15	Professional	TC	$192.00	$309.93	$881.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.55 / $322.23 / $485.13	Professional		$213.55	$322.23	$485.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $121.61 / $159.44	Professional	26	$66.70	$121.61	$159.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $156.40 / $156.40 / $156.40	Professional	TC	$156.40	$156.40	$156.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.46 / $395.81 / $884.66	Professional		$253.46	$395.81	$884.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $107.45 / $230.27	Professional	26	$77.59	$107.45	$230.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.11 / $284.67 / $667.46	Professional	TC	$182.11	$284.67	$667.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.80 / $213.51 / $390.23	Professional		$87.80	$213.51	$390.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.87 / $573.42 / $1,045.52	Professional		$294.87	$573.42	$1,045.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.56 / $145.60 / $260.32	Professional	26	$83.56	$145.60	$260.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.29 / $423.92 / $839.24	Professional	TC	$210.29	$423.92	$839.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $305.52 / $555.50 / $1,504.06	Professional		$305.52	$555.50	$1,504.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.83 / $146.38 / $373.44	Professional	26	$91.83	$146.38	$373.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $213.70 / $388.54 / $1,504.06	Professional	TC	$213.70	$388.54	$1,504.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.65 / $280.56 / $478.33	Professional		$118.65	$280.56	$478.33
United Facility/Professional Professional Modifier Low / Median / High Price $288.27 / $476.09 / $871.42	Professional		$288.27	$476.09	$871.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.78 / $121.63 / $204.32	Professional	26	$85.78	$121.63	$204.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.12 / $365.04 / $701.31	Professional	TC	$210.12	$365.04	$701.31