Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $80.88 / $243.70	Facility	26	$55.00	$80.88	$243.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.17 / $299.31 / $753.76	Professional		$245.17	$299.31	$753.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.17 / $83.00 / $202.51	Professional	26	$53.17	$83.00	$202.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.85 / $220.00 / $533.74	Professional	TC	$186.85	$220.00	$533.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.60 / $198.97 / $413.89	Professional		$170.60	$198.97	$413.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.51 / $74.44 / $101.02	Professional	26	$44.51	$74.44	$101.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.76 / $315.47 / $630.37	Professional		$223.76	$315.47	$630.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $72.20 / $151.63	Professional	26	$51.59	$72.20	$151.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.08 / $230.32 / $503.61	Professional	TC	$171.08	$230.32	$503.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $186.90 / $340.82	Professional		$55.91	$186.90	$340.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.78 / $422.20 / $697.77	Professional		$230.78	$422.20	$697.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $93.39 / $165.55	Professional	26	$53.34	$93.39	$165.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.00 / $307.36 / $572.39	Professional	TC	$175.00	$307.36	$572.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.22 / $445.86 / $860.00	Professional		$245.22	$445.86	$860.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $92.75 / $233.91	Professional	26	$58.18	$92.75	$233.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $187.04 / $340.08 / $860.00	Professional	TC	$187.04	$340.08	$860.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.65 / $207.11 / $377.31	Professional		$68.65	$207.11	$377.31
United Facility/Professional Professional Modifier Low / Median / High Price $229.20 / $352.58 / $645.84	Professional		$229.20	$352.58	$645.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.24 / $74.14 / $130.55	Professional	26	$53.24	$74.14	$130.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.57 / $262.83 / $472.56	Professional	TC	$169.57	$262.83	$472.56