Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $173.78 / $363.08	Facility	26	$85.11	$173.78	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $478.63 / $1,047.13	Professional		$251.19	$478.63	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $131.83 / $331.13	Professional	26	$77.62	$131.83	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $338.84 / $645.65	Professional	TC	$239.88	$338.84	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $616.60	Professional		$213.80	$281.84	$616.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $79.43 / $141.25	Professional	26	$64.57	$79.43	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $181.97 / $213.80	Professional	TC	$181.97	$181.97	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $933.25	Professional		$363.08	$549.54	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $162.18	Professional	26	$72.44	$104.71	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $407.38 / $794.33	Professional	TC	$275.42	$407.38	$794.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $234.42 / $389.05	Professional		$79.43	$234.42	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $645.65 / $1,096.48	Professional		$363.08	$645.65	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $117.49 / $204.17	Professional	26	$70.79	$117.49	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $501.19 / $912.01	Professional	TC	$281.84	$501.19	$912.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $416.87 / $1,584.89	Professional		$323.59	$416.87	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $102.33 / $275.42	Professional	26	$75.86	$102.33	$275.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $316.23 / $1,584.89	Professional	TC	$245.47	$316.23	$1,584.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $288.40 / $524.81	Professional		$79.43	$288.40	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $549.54 / $954.99	Professional		$331.13	$549.54	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $91.20 / $177.83	Professional	26	$72.44	$91.20	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $446.68 / $776.25	Professional	TC	$257.04	$446.68	$776.25