Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $110.76 / $257.05	Facility	26	$55.00	$110.76	$257.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.26 / $282.06 / $740.89	Professional		$185.26	$282.06	$740.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $66.27 / $186.88	Professional	26	$52.78	$66.27	$186.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.19 / $220.00 / $549.84	Professional	TC	$124.19	$220.00	$549.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $220.78 / $220.78 / $220.78	Professional		$220.78	$220.78	$220.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.38 / $72.70 / $103.00	Professional	26	$44.38	$72.70	$103.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.73 / $292.27 / $555.88	Professional		$168.73	$292.27	$555.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.15 / $76.15 / $155.29	Professional	26	$54.15	$76.15	$155.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.39 / $202.26 / $416.17	Professional	TC	$113.39	$202.26	$416.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.71 / $124.94 / $223.09	Professional		$58.71	$124.94	$223.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.46 / $400.24 / $681.86	Professional		$212.46	$400.24	$681.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.59 / $97.96 / $173.64	Professional	26	$55.59	$97.96	$173.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.90 / $282.50 / $515.80	Professional	TC	$157.90	$282.50	$515.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $183.15 / $333.00 / $891.93	Professional		$183.15	$333.00	$891.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.03 / $97.29 / $245.67	Professional	26	$61.03	$97.29	$245.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $122.12 / $222.04 / $891.50	Professional	TC	$122.12	$222.04	$891.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.70 / $167.30 / $307.08	Professional		$79.70	$167.30	$307.08
United Facility/Professional Professional Modifier Low / Median / High Price $195.60 / $331.43 / $566.14	Professional		$195.60	$331.43	$566.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $78.41 / $136.93	Professional	26	$56.15	$78.41	$136.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.87 / $238.59 / $402.94	Professional	TC	$124.87	$238.59	$402.94