Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $88.88 / $243.70	Facility	26	$55.00	$88.88	$243.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.28 / $275.00 / $579.65	Professional		$126.28	$275.00	$579.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.17 / $72.78 / $208.59	Professional	26	$53.17	$72.78	$208.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.97 / $220.00 / $432.45	Professional	TC	$132.97	$220.00	$432.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.14 / $217.14 / $217.14	Professional		$217.14	$217.14	$217.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.51 / $66.73 / $98.06	Professional	26	$44.51	$66.73	$98.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.89 / $286.83 / $534.88	Professional		$166.89	$286.83	$534.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $72.18 / $151.63	Professional	26	$51.59	$72.18	$151.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.28 / $203.76 / $395.17	Professional	TC	$114.28	$203.76	$395.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $122.01 / $223.09	Professional		$55.91	$122.01	$223.09
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 $210.31 / $375.79 / $618.67	Professional		$210.31	$375.79	$618.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $93.39 / $157.50	Professional	26	$53.34	$93.39	$157.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.35 / $268.27 / $486.80	Professional	TC	$158.35	$268.27	$486.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.30 / $327.82 / $853.03	Professional		$180.30	$327.82	$853.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $92.75 / $204.12	Professional	26	$58.18	$92.75	$204.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $122.12 / $222.04 / $765.74	Professional	TC	$122.12	$222.04	$765.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.94 / $167.30 / $302.41	Professional		$75.94	$167.30	$302.41
United Facility/Professional Professional Modifier Low / Median / High Price $192.30 / $319.81 / $553.61	Professional		$192.30	$319.81	$553.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.27 / $74.78 / $130.55	Professional	26	$53.27	$74.78	$130.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.20 / $227.08 / $400.78	Professional	TC	$122.20	$227.08	$400.78