Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $170.34 / $482.91	Facility	26	$85.00	$170.34	$482.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.49 / $475.00 / $2,074.27	Professional		$353.49	$475.00	$2,074.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $173.28 / $389.19	Professional	26	$85.00	$173.28	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $260.13 / $340.00 / $1,020.25	Professional	TC	$260.13	$340.00	$1,020.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $242.66 / $288.11 / $542.77	Professional		$242.66	$288.11	$542.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $88.88 / $153.77 / $196.02	Professional	26	$88.88	$153.77	$196.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.95 / $109.95 / $109.95	Professional	TC	$109.95	$109.95	$109.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.93 / $539.54 / $1,410.30	Professional		$316.93	$539.54	$1,410.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.74 / $142.26 / $301.82	Professional	26	$103.74	$142.26	$301.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.83 / $362.76 / $1,231.42	Professional	TC	$214.83	$362.76	$1,231.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.96 / $238.38 / $420.63	Professional		$110.96	$238.38	$420.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.94 / $855.24 / $1,913.88	Professional		$372.94	$855.24	$1,913.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.64 / $188.98 / $325.00	Professional	26	$111.64	$188.98	$325.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.67 / $581.00 / $1,429.52	Professional	TC	$258.67	$581.00	$1,429.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.51 / $630.02 / $2,891.81	Professional		$346.51	$630.02	$2,891.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $116.14 / $185.15 / $402.13	Professional	26	$116.14	$185.15	$402.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $230.37 / $418.86 / $2,562.56	Professional	TC	$230.37	$418.86	$2,562.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $152.04 / $316.23 / $581.54	Professional		$152.04	$316.23	$581.54
United Facility/Professional Professional Modifier Low / Median / High Price $361.27 / $635.00 / $1,410.67	Professional		$361.27	$635.00	$1,410.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.97 / $153.47 / $281.50	Professional	26	$110.97	$153.47	$281.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $428.81 / $1,085.38	Professional	TC	$239.26	$428.81	$1,085.38