Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $238.84 / $536.41	Facility	26	$85.00	$238.84	$536.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.03 / $475.00 / $1,117.88	Professional		$418.03	$475.00	$1,117.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $169.86 / $358.40	Professional	26	$85.00	$169.86	$358.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.31 / $340.00 / $786.55	Professional	TC	$297.31	$340.00	$786.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.47 / $289.47 / $289.47	Professional		$289.47	$289.47	$289.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.80 / $199.20 / $225.67	Professional	26	$91.80	$199.20	$225.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.48 / $553.71 / $1,171.01	Professional		$359.48	$553.71	$1,171.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.43 / $156.35 / $322.25	Professional	26	$113.43	$156.35	$322.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.24 / $378.34 / $862.50	Professional	TC	$251.24	$378.34	$862.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.76 / $266.48 / $474.93	Professional		$124.76	$266.48	$474.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.66 / $767.00 / $1,391.75	Professional		$428.66	$767.00	$1,391.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.71 / $201.35 / $350.73	Professional	26	$122.71	$201.35	$350.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $298.87 / $579.46 / $1,105.73	Professional	TC	$298.87	$579.46	$1,105.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $390.13 / $621.92 / $3,710.00	Professional		$390.13	$621.92	$3,710.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $129.97 / $207.19 / $1,040.14	Professional	26	$129.97	$207.19	$1,040.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $260.17 / $414.76 / $2,893.80	Professional	TC	$260.17	$414.76	$2,893.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $175.50 / $406.08 / $881.50	Professional		$175.50	$406.08	$881.50
United Facility/Professional Professional Modifier Low / Median / High Price $408.90 / $640.10 / $1,195.35	Professional		$408.90	$640.10	$1,195.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.42 / $171.32 / $291.66	Professional	26	$114.42	$171.32	$291.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.01 / $464.96 / $840.50	Professional	TC	$275.01	$464.96	$840.50