Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $141.41 / $460.66	Facility	26	$85.00	$141.41	$460.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.85 / $475.00 / $1,459.50	Professional		$372.85	$475.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $141.41 / $338.00	Professional	26	$85.00	$141.41	$338.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.05 / $340.00 / $931.29	Professional	TC	$287.05	$340.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $254.54 / $301.97 / $437.86	Professional		$254.54	$301.97	$437.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.05 / $147.13 / $192.95	Professional	26	$85.05	$147.13	$192.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $241.57 / $241.57 / $241.57	Professional	TC	$241.57	$241.57	$241.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.52 / $574.61 / $1,368.09	Professional		$336.52	$574.61	$1,368.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.41 / $133.57 / $276.70	Professional	26	$94.41	$133.57	$276.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.51 / $412.44 / $1,238.75	Professional	TC	$238.51	$412.44	$1,238.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.27 / $252.88 / $461.99	Professional		$106.27	$252.88	$461.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.55 / $885.64 / $1,856.20	Professional		$400.55	$885.64	$1,856.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.20 / $170.96 / $293.32	Professional	26	$103.20	$170.96	$293.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.31 / $685.20 / $1,470.63	Professional	TC	$302.31	$685.20	$1,470.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $364.19 / $662.16 / $2,804.65	Professional		$364.19	$662.16	$2,804.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $111.12 / $175.40 / $397.23	Professional	26	$111.12	$175.40	$397.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $253.08 / $460.14 / $2,485.31	Professional	TC	$253.08	$460.14	$2,485.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $146.06 / $346.60 / $612.50	Professional		$146.06	$346.60	$612.50
United Facility/Professional Professional Modifier Low / Median / High Price $359.72 / $713.86 / $1,326.88	Professional		$359.72	$713.86	$1,326.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.69 / $138.41 / $249.37	Professional	26	$100.69	$138.41	$249.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.95 / $537.51 / $1,119.63	Professional	TC	$274.95	$537.51	$1,119.63