Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $81.97 / $268.95	Facility	26	$55.00	$81.97	$268.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.31 / $312.88 / $962.47	Professional		$256.31	$312.88	$962.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $81.48 / $199.10	Professional	26	$55.00	$81.48	$199.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.49 / $248.90 / $554.76	Professional	TC	$178.49	$248.90	$554.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.82 / $202.47 / $421.17	Professional		$173.82	$202.47	$421.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.90 / $81.78 / $110.97	Professional	26	$48.90	$81.78	$110.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $295.75 / $295.75 / $298.69	Professional	TC	$295.75	$295.75	$298.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.85 / $321.95 / $664.79	Professional		$226.85	$321.95	$664.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.85 / $78.84 / $163.44	Professional	26	$55.85	$78.84	$163.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.50 / $237.60 / $507.16	Professional	TC	$170.50	$237.60	$507.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.31 / $185.49 / $338.81	Professional		$61.31	$185.49	$338.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.91 / $434.00 / $726.93	Professional		$235.91	$434.00	$726.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.68 / $98.50 / $181.87	Professional	26	$58.68	$98.50	$181.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.69 / $308.48 / $592.39	Professional	TC	$174.69	$308.48	$592.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $249.54 / $453.70 / $950.87	Professional		$249.54	$453.70	$950.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.91 / $101.88 / $257.39	Professional	26	$63.91	$101.88	$257.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $185.63 / $337.50 / $876.82	Professional	TC	$185.63	$337.50	$876.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $218.32 / $411.67	Professional		$78.95	$218.32	$411.67
United Facility/Professional Professional Modifier Low / Median / High Price $234.23 / $367.88 / $642.52	Professional		$234.23	$367.88	$642.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.45 / $81.98 / $143.41	Professional	26	$58.45	$81.98	$143.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.86 / $272.67 / $493.03	Professional	TC	$168.86	$272.67	$493.03