Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $257.04 / $575.44	Facility	26	$85.11	$257.04	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $501.19 / $1,380.38	Professional		$371.54	$501.19	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $208.93 / $562.34	Professional	26	$93.33	$208.93	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $630.96	Professional	TC	$251.19	$338.84	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $173.78 / $223.87	Professional	26	$112.20	$173.78	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $575.44 / $1,174.90	Professional		$416.87	$575.44	$1,174.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $162.18 / $269.15	Professional	26	$107.15	$162.18	$269.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $912.01	Professional	TC	$281.84	$416.87	$912.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $446.68	Professional		$125.89	$257.04	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $758.58 / $1,380.38	Professional		$426.58	$758.58	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $186.21 / $323.59	Professional	26	$114.82	$186.21	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $537.03 / $977.24	Professional	TC	$288.40	$537.03	$977.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $3,467.37	Professional		$371.54	$478.63	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $158.49 / $831.76	Professional	26	$120.23	$158.49	$831.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $323.59 / $2,454.71	Professional	TC	$251.19	$323.59	$2,454.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $354.81 / $812.83	Professional		$177.83	$354.81	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $645.65 / $1,122.02	Professional		$380.19	$645.65	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $151.36 / $281.84	Professional	26	$114.82	$151.36	$281.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $457.09 / $831.76	Professional	TC	$269.15	$457.09	$831.76