Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $114.82 / $275.42	Facility	26	$54.95	$114.82	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $1,023.29	Professional		$223.87	$316.23	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $93.33 / $229.09	Professional	26	$54.95	$93.33	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $223.87 / $446.68	Professional	TC	$158.49	$223.87	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $204.17 / $380.19	Professional		$154.88	$204.17	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $81.28 / $112.20	Professional	26	$47.86	$81.28	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $131.83 / $131.83	Professional	TC	$131.83	$131.83	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $588.84	Professional		$239.88	$331.13	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $131.83	Professional	26	$53.70	$83.18	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $245.47 / $467.74	Professional	TC	$186.21	$245.47	$467.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $186.21 / $288.40	Professional		$61.66	$186.21	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $416.87 / $707.95	Professional		$234.42	$416.87	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $91.20 / $162.18	Professional	26	$54.95	$91.20	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $295.12 / $562.34	Professional	TC	$169.82	$295.12	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $870.96	Professional		$234.42	$302.00	$870.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $257.04	Professional	26	$58.88	$79.43	$257.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $870.96	Professional	TC	$173.78	$229.09	$870.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $190.55 / $380.19	Professional		$60.26	$190.55	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $346.74 / $602.56	Professional		$223.87	$346.74	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $141.25	Professional	26	$57.54	$75.86	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $263.03 / $467.74	Professional	TC	$165.96	$263.03	$467.74