Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $98.59 / $313.52	Facility	26	$85.00	$98.59	$313.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.09 / $425.00 / $1,021.88	Professional		$182.09	$425.00	$1,021.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $108.44 / $240.00	Professional	26	$67.59	$108.44	$240.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $116.80 / $212.50 / $523.97	Professional	52	$116.80	$212.50	$523.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.73 / $335.00 / $551.54	Professional	TC	$109.73	$335.00	$551.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.53 / $171.96 / $328.44	Professional		$126.53	$171.96	$328.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.97 / $98.76 / $125.95	Professional	26	$55.97	$98.76	$125.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.50 / $208.56 / $208.56	Professional	TC	$109.50	$208.56	$208.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.67 / $365.69 / $757.14	Professional		$188.67	$365.69	$757.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $99.05 / $190.98	Professional	26	$67.59	$99.05	$190.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.65 / $207.31 / $615.55	Professional	TC	$121.65	$207.31	$615.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.59 / $148.43 / $240.55	Professional		$71.59	$148.43	$240.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.00 / $524.29 / $968.66	Professional		$221.00	$524.29	$968.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $122.25 / $209.97	Professional	26	$71.81	$122.25	$209.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.88 / $373.21 / $775.40	Professional	TC	$145.88	$373.21	$775.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.33 / $375.14 / $1,365.67	Professional		$206.33	$375.14	$1,365.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.62 / $118.96 / $260.68	Professional	26	$74.62	$118.96	$260.68
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $171.77 / $171.77 / $241.39	Professional	52	$171.77	$171.77	$241.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $131.69 / $239.46 / $1,210.18	Professional	TC	$131.69	$239.46	$1,210.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.74 / $182.96 / $347.00	Professional		$96.74	$182.96	$347.00
United Facility/Professional Professional Modifier Low / Median / High Price $213.89 / $393.56 / $904.18	Professional		$213.89	$393.56	$904.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.90 / $98.84 / $167.47	Professional	26	$68.90	$98.84	$167.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.91 / $230.51 / $567.64	Professional	TC	$129.91	$230.51	$567.64