Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $131.83 / $316.23	Facility	26	$85.11	$131.83	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $1,174.90	Professional		$213.80	$426.58	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $123.03 / $316.23	Professional	26	$66.07	$123.03	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $295.12 / $562.34	Professional	TC	$144.54	$295.12	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $218.78	Professional		$128.82	$169.82	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $125.89	Professional	26	$53.70	$83.18	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	TC	$162.18	$162.18	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $467.74 / $776.25	Professional		$234.42	$467.74	$776.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $95.50 / $151.36	Professional	26	$70.79	$95.50	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $338.84 / $660.69	Professional	TC	$158.49	$338.84	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $138.04 / $245.47	Professional		$70.79	$138.04	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $512.86 / $912.01	Professional		$229.09	$512.86	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $104.71 / $194.98	Professional	26	$63.10	$104.71	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $363.08 / $741.31	Professional	TC	$169.82	$363.08	$741.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $1,318.26	Professional		$194.98	$257.04	$1,318.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $91.20 / $245.47	Professional	26	$67.61	$91.20	$245.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $169.82 / $1,258.93	Professional	TC	$128.82	$169.82	$1,258.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $354.81	Professional		$69.18	$147.91	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $416.87 / $724.44	Professional		$208.93	$416.87	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $83.18 / $162.18	Professional	26	$64.57	$83.18	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $275.42 / $549.54	Professional	TC	$138.04	$275.42	$549.54