Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $107.15 / $295.12	Facility	26	$85.11	$107.15	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $354.81 / $1,000.00	Professional		$64.57	$354.81	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $125.89 / $331.13	Professional	26	$61.66	$125.89	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $251.19 / $954.99 / $1,949.84	Professional	50	$251.19	$954.99	$1,949.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.62 / $31.62 / $1,023.29	Professional	52	$31.62	$31.62	$1,023.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $323.59 / $691.83	Professional	TC	$141.25	$323.59	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $346.74	Professional		$154.88	$208.93	$346.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $79.43 / $114.82	Professional	26	$48.98	$79.43	$114.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $562.34 / $602.56	Professional	50	$354.81	$562.34	$602.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $125.89 / $239.88	Professional	TC	$104.71	$125.89	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $467.74 / $776.25	Professional		$229.09	$467.74	$776.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $87.10 / $138.04	Professional	26	$66.07	$87.10	$138.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $331.13 / $707.95 / $1,148.15	Professional	50	$331.13	$707.95	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $323.59 / $660.69	Professional	TC	$169.82	$323.59	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $151.36 / $251.19	Professional		$66.07	$151.36	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $501.19 / $933.25	Professional		$218.78	$501.19	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $97.72 / $181.97	Professional	26	$58.88	$97.72	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $346.74 / $812.83	Professional	TC	$158.49	$346.74	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $1,318.26	Professional		$208.93	$269.15	$1,318.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $85.11 / $229.09	Professional	26	$63.10	$85.11	$229.09
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $181.97 / $257.04	Professional	52	$181.97	$181.97	$257.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $186.21 / $1,318.26	Professional	TC	$144.54	$186.21	$1,318.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $190.55 / $346.74	Professional		$66.07	$190.55	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $398.11 / $758.58	Professional		$208.93	$398.11	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $147.91	Professional	26	$60.26	$75.86	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $269.15 / $602.56	Professional	TC	$147.91	$269.15	$602.56