Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $156.57 / $460.66	Facility	26	$85.00	$156.57	$460.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.82 / $494.18 / $1,775.28	Professional		$372.82	$494.18	$1,775.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $425.49	Professional	26	$85.00	$140.00	$425.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.42 / $348.53 / $1,020.25	Professional	TC	$288.42	$348.53	$1,020.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.58 / $296.64 / $481.94	Professional		$223.58	$296.64	$481.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.38 / $147.13 / $187.55	Professional	26	$83.38	$147.13	$187.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $403.32 / $403.32 / $403.32	Professional	TC	$403.32	$403.32	$403.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.13 / $569.99 / $1,368.09	Professional		$337.13	$569.99	$1,368.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.41 / $130.47 / $276.70	Professional	26	$94.41	$130.47	$276.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.11 / $405.73 / $1,240.28	Professional	TC	$239.11	$405.73	$1,240.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.27 / $254.29 / $464.58	Professional		$106.27	$254.29	$464.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.90 / $887.50 / $1,856.20	Professional		$400.90	$887.50	$1,856.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.20 / $170.96 / $293.32	Professional	26	$103.20	$170.96	$293.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.69 / $687.06 / $1,472.07	Professional	TC	$302.69	$687.06	$1,472.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $365.61 / $664.74 / $2,804.65	Professional		$365.61	$664.74	$2,804.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $111.12 / $175.40 / $397.23	Professional	26	$111.12	$175.40	$397.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $254.50 / $462.72 / $2,485.31	Professional	TC	$254.50	$462.72	$2,485.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $142.74 / $344.73 / $613.79	Professional		$142.74	$344.73	$613.79
United Facility/Professional Professional Modifier Low / Median / High Price $380.57 / $719.21 / $1,464.57	Professional		$380.57	$719.21	$1,464.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.63 / $142.94 / $249.37	Professional	26	$100.63	$142.94	$249.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.30 / $541.29 / $1,121.20	Professional	TC	$261.30	$541.29	$1,121.20