Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $101.94 / $285.31	Facility	26	$85.00	$101.94	$285.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.02 / $475.00 / $971.50	Professional		$243.02	$475.00	$971.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.66 / $110.00 / $316.27	Professional	26	$78.66	$110.00	$316.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.00 / $340.00 / $777.14	Professional	TC	$249.00	$340.00	$777.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.14 / $264.11 / $549.41	Professional		$226.14	$264.11	$549.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.11 / $90.20 / $118.38	Professional	26	$51.11	$90.20	$118.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $409.35 / $409.35 / $409.35	Professional	TC	$409.35	$409.35	$409.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.29 / $488.00 / $941.64	Professional		$296.29	$488.00	$941.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.26 / $83.50 / $171.37	Professional	26	$59.26	$83.50	$171.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $233.94 / $384.99 / $793.16	Professional	TC	$233.94	$384.99	$793.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.47 / $257.13 / $451.53	Professional		$65.47	$257.13	$451.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.45 / $623.72 / $1,066.56	Professional		$360.45	$623.72	$1,066.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $104.27 / $194.00	Professional	26	$61.68	$104.27	$194.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $282.37 / $492.92 / $897.17	Professional	TC	$282.37	$492.92	$897.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $325.51 / $591.84 / $1,474.25	Professional		$325.51	$591.84	$1,474.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $104.68 / $238.56	Professional	26	$68.18	$104.68	$238.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.33 / $467.88 / $1,307.91	Professional	TC	$257.33	$467.88	$1,307.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.53 / $308.68 / $554.72	Professional		$89.53	$308.68	$554.72
United Facility/Professional Professional Modifier Low / Median / High Price $340.45 / $519.57 / $963.87	Professional		$340.45	$519.57	$963.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.23 / $85.70 / $159.28	Professional	26	$61.23	$85.70	$159.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.17 / $419.99 / $794.06	Professional	TC	$260.17	$419.99	$794.06