Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $102.33 / $251.19	Facility	26	$54.95	$102.33	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $302.00 / $707.95	Professional		$208.93	$302.00	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $199.53	Professional	26	$52.48	$85.11	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $436.52	Professional	TC	$158.49	$218.78	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $245.47	Professional		$147.91	$147.91	$245.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $95.50	Professional	26	$43.65	$63.10	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $112.20 / $218.78	Professional	TC	$112.20	$112.20	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $323.59 / $562.34	Professional		$239.88	$323.59	$562.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $117.49	Professional	26	$51.29	$75.86	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $239.88 / $457.09	Professional	TC	$186.21	$239.88	$457.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $186.21 / $281.84	Professional		$56.23	$186.21	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $398.11 / $691.83	Professional		$229.09	$398.11	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $83.18 / $151.36	Professional	26	$50.12	$83.18	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $295.12 / $549.54	Professional	TC	$169.82	$295.12	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $851.14	Professional		$229.09	$295.12	$851.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $74.13 / $234.42	Professional	26	$53.70	$74.13	$234.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $851.14	Professional	TC	$173.78	$229.09	$851.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $190.55 / $380.19	Professional		$56.23	$190.55	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $331.13 / $588.84	Professional		$218.78	$331.13	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $128.82	Professional	26	$51.29	$69.18	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $263.03 / $446.68	Professional	TC	$165.96	$263.03	$446.68