Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.61 / $277.89 / $1,377.28	Facility		$96.61	$277.89	$1,377.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.28 / $48.51 / $172.38	Facility	26	$33.28	$48.51	$172.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.93 / $173.80 / $317.54	Professional		$95.93	$173.80	$317.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $51.06 / $104.54	Professional	26	$33.04	$51.06	$104.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.40 / $99.56 / $212.57	Professional	TC	$63.40	$99.56	$212.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $146.47 / $191.97	Professional		$87.01	$146.47	$191.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.83 / $52.11 / $70.69	Professional	26	$29.83	$52.11	$70.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.29 / $123.32 / $132.57	Professional	TC	$63.29	$123.32	$132.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.97 / $214.01 / $276.00	Facility		$110.97	$214.01	$276.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.57 / $152.63 / $291.11	Professional		$105.57	$152.63	$291.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.67 / $50.92 / $90.39	Professional	26	$33.67	$50.92	$90.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.31 / $101.59 / $202.54	Professional	TC	$69.31	$101.59	$202.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.90 / $95.47 / $156.57	Facility		$46.90	$95.47	$156.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $83.49 / $150.69	Professional		$38.10	$83.49	$150.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.47 / $172.50 / $248.00	Facility		$107.47	$172.50	$248.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.72 / $180.06 / $307.75	Professional		$116.72	$180.06	$307.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $57.83 / $101.68	Professional	26	$38.84	$57.83	$101.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.48 / $123.44 / $206.84	Professional	TC	$77.48	$123.44	$206.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.92 / $143.30 / $356.99	Professional		$111.92	$143.30	$356.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.01 / $48.11 / $117.53	Professional	26	$37.01	$48.11	$117.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.90 / $92.99 / $318.05	Professional	TC	$74.90	$92.99	$318.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $114.62 / $183.00 / $216.37	Facility		$114.62	$183.00	$216.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.02 / $109.40 / $192.89	Professional		$48.02	$109.40	$192.89
United Facility/Professional Professional Modifier Low / Median / High Price $114.79 / $158.38 / $266.47	Professional		$114.79	$158.38	$266.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.42 / $51.90 / $89.17	Professional	26	$39.42	$51.90	$89.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.05 / $108.71 / $177.80	Professional	TC	$74.05	$108.71	$177.80