Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $69.65 / $210.99	Facility	26	$55.00	$69.65	$210.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.21 / $275.00 / $636.38	Professional		$156.21	$275.00	$636.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.25 / $66.00 / $177.93	Professional	26	$45.25	$66.00	$177.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.36 / $220.00 / $402.60	Professional	TC	$109.36	$220.00	$402.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.32 / $104.42 / $113.97	Professional		$98.32	$104.42	$113.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.74 / $63.92 / $86.75	Professional	26	$31.74	$63.92	$86.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.24 / $240.96 / $457.31	Professional		$132.24	$240.96	$457.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.42 / $68.56 / $130.22	Professional	26	$45.42	$68.56	$130.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.80 / $158.53 / $335.79	Professional	TC	$84.80	$158.53	$335.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $102.01 / $165.20	Professional		$48.08	$102.01	$165.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.98 / $316.52 / $569.24	Professional		$165.98	$316.52	$569.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.33 / $83.23 / $144.00	Professional	26	$48.33	$83.23	$144.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.28 / $226.95 / $428.23	Professional	TC	$117.28	$226.95	$428.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.46 / $255.38 / $765.74	Professional		$140.46	$255.38	$765.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.96 / $83.51 / $233.91	Professional	26	$49.96	$83.51	$233.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.51 / $164.56 / $765.74	Professional	TC	$90.51	$164.56	$765.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.40 / $122.85 / $235.26	Professional		$65.40	$122.85	$235.26
United Facility/Professional Professional Modifier Low / Median / High Price $150.09 / $268.72 / $471.40	Professional		$150.09	$268.72	$471.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.46 / $69.16 / $112.33	Professional	26	$48.46	$69.16	$112.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.79 / $184.59 / $309.08	Professional	TC	$97.79	$184.59	$309.08