Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $106.28 / $497.82	Facility	26	$55.00	$106.28	$497.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $335.52 / $944.37	Professional		$275.00	$335.52	$944.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $171.96 / $387.43	Professional	26	$55.00	$171.96	$387.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $242.00 / $523.84	Professional	TC	$192.00	$242.00	$523.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.26 / $260.06 / $590.86	Professional		$245.26	$260.06	$590.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $94.85 / $184.36 / $223.22	Professional	26	$94.85	$184.36	$223.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $168.09 / $168.09 / $168.09	Professional	TC	$168.09	$168.09	$168.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.42 / $508.05 / $953.72	Professional		$286.42	$508.05	$953.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.55 / $145.30 / $280.89	Professional	26	$107.55	$145.30	$280.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $188.41 / $341.62 / $705.72	Professional	TC	$188.41	$341.62	$705.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.35 / $246.94 / $419.68	Professional		$115.35	$246.94	$419.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.94 / $128.94 / $128.94	Facility	26	$128.94	$128.94	$128.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.00 / $655.61 / $1,234.74	Professional		$374.00	$655.61	$1,234.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.09 / $174.96 / $324.55	Professional	26	$105.09	$174.96	$324.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.80 / $495.77 / $928.37	Professional	TC	$261.80	$495.77	$928.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $350.08 / $558.08 / $2,292.00	Professional		$350.08	$558.08	$2,292.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $120.36 / $191.88 / $458.40	Professional	26	$120.36	$191.88	$458.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $229.70 / $366.19 / $1,833.60	Professional	TC	$229.70	$366.19	$1,833.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $153.19 / $317.20 / $548.40	Professional		$153.19	$317.20	$548.40
United Facility/Professional Professional Modifier Low / Median / High Price $342.46 / $611.91 / $1,031.64	Professional		$342.46	$611.91	$1,031.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.81 / $155.38 / $267.39	Professional	26	$108.81	$155.38	$267.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.86 / $415.97 / $729.40	Professional	TC	$232.86	$415.97	$729.40