Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $86.11 / $285.31	Facility	26	$85.00	$86.11	$285.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $415.70 / $921.70	Professional		$85.00	$415.70	$921.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.04 / $119.47 / $315.94	Professional	26	$65.04	$119.47	$315.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $621.08 / $954.32 / $1,941.27	Professional	50	$621.08	$954.32	$1,941.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $111.29 / $212.50 / $485.32	Professional	52	$111.29	$212.50	$485.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.87 / $340.00 / $783.89	Professional	TC	$129.87	$340.00	$783.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.22 / $184.77 / $306.75	Professional		$155.22	$184.77	$306.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.59 / $84.34 / $115.07	Professional	26	$49.59	$84.34	$115.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $126.31 / $238.16 / $238.16	Professional	TC	$126.31	$238.16	$238.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.22 / $377.95 / $730.88	Professional		$200.22	$377.95	$730.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.95 / $84.05 / $173.31	Professional	26	$59.95	$84.05	$173.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $295.80 / $556.64 / $1,099.50	Professional	50	$295.80	$556.64	$1,099.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.93 / $236.75 / $601.28	Professional	TC	$138.93	$236.75	$601.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.47 / $151.81 / $277.74	Professional		$65.47	$151.81	$277.74
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 $224.83 / $523.54 / $996.38	Professional		$224.83	$523.54	$996.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $105.58 / $189.14	Professional	26	$61.68	$105.58	$189.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.90 / $405.22 / $833.50	Professional	TC	$162.90	$405.22	$833.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $220.15 / $400.28 / $1,419.11	Professional		$220.15	$400.28	$1,419.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $108.69 / $238.56	Professional	26	$68.18	$108.69	$238.56
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $183.28 / $183.28 / $257.56	Professional	52	$183.28	$183.28	$257.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $151.97 / $276.30 / $1,307.91	Professional	TC	$151.97	$276.30	$1,307.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.53 / $208.61 / $370.26	Professional		$89.53	$208.61	$370.26
United Facility/Professional Professional Modifier Low / Median / High Price $225.38 / $406.12 / $818.72	Professional		$225.38	$406.12	$818.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.23 / $86.08 / $151.90	Professional	26	$61.23	$86.08	$151.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.36 / $260.45 / $596.17	Professional	TC	$149.36	$260.45	$596.17