Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $82.41 / $251.11	Facility	26	$55.00	$82.41	$251.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $275.00 / $705.70	Professional		$155.40	$275.00	$705.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.42 / $80.41 / $185.53	Professional	26	$54.42	$80.41	$185.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.23 / $220.00 / $433.59	Professional	TC	$101.23	$220.00	$433.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $119.78 / $249.16	Professional		$103.61	$119.78	$249.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.94 / $76.26 / $100.59	Professional	26	$46.94	$76.26	$100.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.77 / $237.58 / $460.39	Professional		$134.77	$237.58	$460.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $74.31 / $150.85	Professional	26	$53.79	$74.31	$150.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.98 / $138.00 / $317.54	Professional	TC	$80.98	$138.00	$317.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $99.21 / $172.77	Professional		$57.31	$99.21	$172.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.51 / $316.66 / $546.11	Professional		$148.51	$316.66	$546.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $92.05 / $169.60	Professional	26	$54.82	$92.05	$169.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.67 / $203.79 / $409.53	Professional	TC	$89.67	$203.79	$409.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.62 / $268.39 / $744.97	Professional		$147.62	$268.39	$744.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.60 / $95.01 / $239.80	Professional	26	$59.60	$95.01	$239.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $88.02 / $160.04 / $744.97	Professional	TC	$88.02	$160.04	$744.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.52 / $121.45 / $250.06	Professional		$65.52	$121.45	$250.06
United Facility/Professional Professional Modifier Low / Median / High Price $140.77 / $232.37 / $426.33	Professional		$140.77	$232.37	$426.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $76.13 / $133.69	Professional	26	$54.86	$76.13	$133.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.82 / $154.00 / $356.18	Professional	TC	$85.82	$154.00	$356.18