Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.41 / $93.60 / $283.83	Facility	26	$84.41	$93.60	$283.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.94 / $425.00 / $905.25	Professional		$152.94	$425.00	$905.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.08 / $111.57 / $313.00	Professional	26	$68.08	$111.57	$313.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,677.00 / $1,677.00 / $1,677.00	Professional	50	$1,677.00	$1,677.00	$1,677.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $195.64 / $340.00 / $724.19	Professional	TC	$195.64	$340.00	$724.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.86 / $185.98 / $228.18	Professional		$167.86	$185.98	$228.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.38 / $77.81 / $114.48	Professional	26	$47.38	$77.81	$114.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $274.36 / $274.36 / $274.36	Professional	TC	$274.36	$274.36	$274.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.99 / $425.00 / $801.24	Professional		$221.99	$425.00	$801.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $83.50 / $170.48	Professional	26	$59.19	$83.50	$170.48
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $332.98 / $645.84 / $1,201.85	Professional	50	$332.98	$645.84	$1,201.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $161.55 / $307.91 / $685.41	Professional	TC	$161.55	$307.91	$685.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $172.71 / $315.52	Professional		$65.14	$172.71	$315.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.52 / $557.14 / $1,019.90	Professional		$266.52	$557.14	$1,019.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $104.27 / $192.99	Professional	26	$61.68	$104.27	$192.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.88 / $434.54 / $857.84	Professional	TC	$203.88	$434.54	$857.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $240.68 / $437.60 / $1,448.56	Professional		$240.68	$437.60	$1,448.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.83 / $104.68 / $237.32	Professional	26	$67.83	$104.68	$237.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $172.85 / $314.27 / $1,307.91	Professional	TC	$172.85	$314.27	$1,307.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.12 / $235.71 / $404.78	Professional		$89.12	$235.71	$404.78
United Facility/Professional Professional Modifier Low / Median / High Price $259.17 / $467.30 / $903.14	Professional		$259.17	$467.30	$903.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.23 / $84.85 / $158.27	Professional	26	$61.23	$84.85	$158.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.08 / $360.40 / $668.88	Professional	TC	$188.08	$360.40	$668.88