Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $120.23 / $275.42	Facility	26	$54.95	$120.23	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $549.54	Professional		$169.82	$275.42	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $199.53	Professional	26	$51.29	$75.86	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $218.78 / $371.54	Professional	TC	$112.20	$218.78	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $223.87	Professional		$213.80	$213.80	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $72.44 / $107.15	Professional	26	$42.66	$72.44	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $549.54	Professional		$204.17	$309.03	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $79.43 / $125.89	Professional	26	$52.48	$79.43	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $426.58	Professional	TC	$144.54	$218.78	$426.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $112.20 / $208.93	Professional		$58.88	$112.20	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $371.54 / $645.65	Professional		$199.53	$371.54	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $87.10 / $158.49	Professional	26	$53.70	$87.10	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $269.15 / $489.78	Professional	TC	$144.54	$269.15	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $891.25	Professional		$169.82	$223.87	$891.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $77.62 / $245.47	Professional	26	$57.54	$77.62	$245.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $147.91 / $891.25	Professional	TC	$114.82	$147.91	$891.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $125.89 / $288.40	Professional		$58.88	$125.89	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $524.81	Professional		$181.97	$316.23	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $72.44 / $134.90	Professional	26	$53.70	$72.44	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $234.42 / $398.11	Professional	TC	$123.03	$234.42	$398.11