Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $125.89 / $331.13	Facility	26	$54.95	$125.89	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $194.98 / $407.38	Professional		$131.83	$194.98	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $275.42	Professional	26	$54.95	$85.11	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $109.65 / $239.88	Professional	TC	$67.61	$109.65	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $169.82	Professional		$83.18	$83.18	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $120.23	Professional	26	$56.23	$87.10	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $501.19	Professional		$125.89	$239.88	$501.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $77.62 / $128.82	Professional	26	$57.54	$77.62	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $114.82 / $389.05	Professional	TC	$67.61	$114.82	$389.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $158.49	Professional		$54.95	$81.28	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $245.47 / $467.74	Professional		$128.82	$245.47	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $91.20 / $162.18	Professional	26	$54.95	$91.20	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $134.90 / $281.84	Professional	TC	$63.10	$134.90	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $1,230.27	Professional		$125.89	$151.36	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.28 / $288.40	Professional	26	$67.61	$81.28	$288.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $67.61 / $645.65	Professional	TC	$56.23	$67.61	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $109.65 / $213.80	Professional		$56.23	$109.65	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $389.05	Professional		$131.83	$204.17	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $79.43 / $151.36	Professional	26	$57.54	$79.43	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $112.20 / $288.40	Professional	TC	$67.61	$112.20	$288.40