Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $155.38 / $344.72	Facility	26	$85.00	$155.38	$344.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $1,039.64	Professional		$250.00	$475.00	$1,039.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $132.38 / $357.64	Professional	26	$85.00	$132.38	$357.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $289.26 / $348.53 / $866.36	Professional	TC	$289.26	$348.53	$866.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.95 / $273.95 / $467.97	Professional		$273.95	$273.95	$467.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $121.56 / $141.93	Professional	26	$57.11	$121.56	$141.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.88 / $520.00 / $1,006.93	Professional		$310.88	$520.00	$1,006.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.23 / $100.34 / $207.08	Professional	26	$72.23	$100.34	$207.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.66 / $383.11 / $807.71	Professional	TC	$242.66	$383.11	$807.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.53 / $255.71 / $467.17	Professional		$78.53	$255.71	$467.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.74 / $667.80 / $1,189.59	Professional		$374.74	$667.80	$1,189.59
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 $291.75 / $530.79 / $1,021.13	Professional	TC	$291.75	$530.79	$1,021.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.65 / $613.90 / $1,569.69	Professional		$337.65	$613.90	$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 $255.92 / $465.30 / $1,569.69	Professional	TC	$255.92	$465.30	$1,569.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $344.53 / $567.86	Professional		$107.34	$344.53	$567.86
United Facility/Professional Professional Modifier Low / Median / High Price $352.88 / $559.41 / $1,014.48	Professional		$352.88	$559.41	$1,014.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.47 / $102.47 / $183.53	Professional	26	$73.47	$102.47	$183.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.39 / $466.00 / $839.83	Professional	TC	$273.39	$466.00	$839.83