Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $149.66 / $451.72	Facility	26	$85.00	$149.66	$451.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.05 / $475.00 / $1,459.50	Professional		$250.05	$475.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $145.65 / $473.51	Professional	26	$85.00	$145.65	$473.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $349.36 / $1,020.25	Professional	TC	$335.00	$349.36	$1,020.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.09 / $496.81 / $654.01	Professional		$253.09	$496.81	$654.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.40 / $141.00 / $189.24	Professional	26	$83.40	$141.00	$189.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $254.48 / $254.48 / $254.48	Professional	TC	$254.48	$254.48	$254.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.51 / $588.73 / $1,395.28	Professional		$381.51	$588.73	$1,395.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.25 / $128.47 / $271.33	Professional	26	$92.25	$128.47	$271.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $284.20 / $462.98 / $1,222.09	Professional	TC	$284.20	$462.98	$1,222.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.16 / $305.70 / $558.33	Professional		$104.16	$305.70	$558.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $461.69 / $924.13 / $1,840.84	Professional		$461.69	$924.13	$1,840.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.57 / $162.84 / $285.43	Professional	26	$98.57	$162.84	$285.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $341.73 / $727.59 / $1,407.49	Professional	TC	$341.73	$727.59	$1,407.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $414.92 / $675.00 / $2,781.45	Professional		$414.92	$675.00	$2,781.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.99 / $167.45 / $377.57	Professional	26	$108.99	$167.45	$377.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $305.93 / $556.24 / $2,781.45	Professional	TC	$305.93	$556.24	$2,781.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $400.49 / $696.06	Professional		$143.22	$400.49	$696.06
United Facility/Professional Professional Modifier Low / Median / High Price $434.69 / $733.34 / $1,366.76	Professional		$434.69	$733.34	$1,366.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $136.76 / $240.49	Professional	26	$97.98	$136.76	$240.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $330.53 / $583.54 / $1,190.59	Professional	TC	$330.53	$583.54	$1,190.59