Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $154.13 / $344.72	Facility	26	$85.00	$154.13	$344.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $1,039.68	Professional		$250.00	$475.00	$1,039.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $264.00	Professional	26	$85.00	$140.00	$264.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $289.49 / $348.53 / $783.89	Professional	TC	$289.49	$348.53	$783.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $233.75 / $272.51 / $465.56	Professional		$233.75	$272.51	$465.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $67.40 / $141.93	Professional	26	$57.11	$67.40	$141.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.29 / $520.00 / $1,005.89	Professional		$310.29	$520.00	$1,005.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $100.34 / $207.08	Professional	26	$71.84	$100.34	$207.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.07 / $389.48 / $805.48	Professional	TC	$242.07	$389.48	$805.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.53 / $253.94 / $463.95	Professional		$78.53	$253.94	$463.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.97 / $662.22 / $1,180.91	Professional		$372.97	$662.22	$1,180.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.41 / $134.00 / $222.44	Professional	26	$74.41	$134.00	$222.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.97 / $530.79 / $1,012.43	Professional	TC	$289.97	$530.79	$1,012.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $335.87 / $610.67 / $1,569.69	Professional		$335.87	$610.67	$1,569.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.73 / $130.31 / $285.33	Professional	26	$81.73	$130.31	$285.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $254.13 / $462.06 / $1,569.69	Professional	TC	$254.13	$462.06	$1,569.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $344.00 / $569.49	Professional		$107.34	$344.00	$569.49
United Facility/Professional Professional Modifier Low / Median / High Price $352.79 / $560.97 / $994.91	Professional		$352.79	$560.97	$994.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.47 / $100.01 / $183.53	Professional	26	$73.47	$100.01	$183.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.25 / $431.44 / $785.56	Professional	TC	$273.25	$431.44	$785.56