Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $194.98 / $467.74	Facility	26	$85.11	$194.98	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $478.63 / $1,412.54	Professional		$239.88	$478.63	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $173.78 / $478.63	Professional	26	$91.20	$173.78	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $371.54 / $870.96	Professional	TC	$269.15	$371.54	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $660.69	Professional		$257.04	$338.84	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $186.21	Professional	26	$83.18	$123.03	$186.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $251.19 / $371.54	Professional	TC	$218.78	$251.19	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $1,445.44	Professional		$446.68	$616.60	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $213.80	Professional	26	$85.11	$131.83	$213.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $501.19 / $1,288.25	Professional	TC	$346.74	$501.19	$1,288.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $281.84 / $478.63	Professional		$104.71	$281.84	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $831.76 / $1,621.81	Professional		$446.68	$831.76	$1,621.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $154.88 / $269.15	Professional	26	$93.33	$154.88	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $616.60 / $1,230.27	Professional	TC	$331.13	$616.60	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $501.19 / $2,754.23	Professional		$389.05	$501.19	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $363.08	Professional	26	$100.00	$134.90	$363.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $371.54 / $2,754.23	Professional	TC	$288.40	$371.54	$2,754.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $354.81 / $645.65	Professional		$104.71	$354.81	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $707.95 / $1,318.26	Professional		$407.38	$707.95	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $120.23 / $234.42	Professional	26	$95.50	$120.23	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $562.34 / $1,071.52	Professional	TC	$316.23	$562.34	$1,071.52