Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $195.66 / $482.91	Facility	26	$85.00	$195.66	$482.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.39 / $475.00 / $2,078.35	Professional		$385.39	$475.00	$2,078.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $181.04 / $439.23	Professional	26	$85.00	$181.04	$439.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $260.89 / $340.00 / $815.42	Professional	TC	$260.89	$340.00	$815.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $243.15 / $257.64 / $447.45	Professional		$243.15	$257.64	$447.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $148.63 / $196.02	Professional	26	$80.69	$148.63	$196.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $220.57 / $220.57 / $220.57	Professional	TC	$220.57	$220.57	$220.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.54 / $537.71 / $1,412.72	Professional		$317.54	$537.71	$1,412.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.74 / $142.26 / $299.58	Professional	26	$103.74	$142.26	$299.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $215.43 / $363.86 / $1,229.85	Professional	TC	$215.43	$363.86	$1,229.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.96 / $238.38 / $421.91	Professional		$110.96	$238.38	$421.91
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 $361.71 / $856.89 / $1,902.85	Professional		$361.71	$856.89	$1,902.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.16 / $188.57 / $326.70	Professional	26	$111.16	$188.57	$326.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $256.44 / $601.03 / $1,354.25	Professional	TC	$256.44	$601.03	$1,354.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $347.22 / $631.29 / $2,889.81	Professional		$347.22	$631.29	$2,889.81
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 $231.08 / $420.14 / $2,560.78	Professional	TC	$231.08	$420.14	$2,560.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $152.04 / $317.20 / $582.77	Professional		$152.04	$317.20	$582.77
United Facility/Professional Professional Modifier Low / Median / High Price $373.46 / $673.70 / $1,472.22	Professional		$373.46	$673.70	$1,472.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.66 / $153.83 / $264.33	Professional	26	$109.66	$153.83	$264.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.21 / $416.53 / $1,021.98	Professional	TC	$235.21	$416.53	$1,021.98