Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $103.56 / $312.05	Facility	26	$55.00	$103.56	$312.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.21 / $275.00 / $590.33	Professional		$147.21	$275.00	$590.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $68.58 / $195.27	Professional	26	$52.54	$68.58	$195.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.71 / $220.00 / $277.38	Professional	TC	$88.71	$220.00	$277.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.57 / $212.30 / $212.30	Professional		$83.57	$212.30	$212.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.37 / $97.71 / $124.24	Professional	26	$55.37	$97.71	$124.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.97 / $207.80 / $457.12	Professional		$127.97	$207.80	$457.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.32 / $81.91 / $171.01	Professional	26	$58.32	$81.91	$171.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.80 / $101.40 / $290.07	Professional	TC	$64.80	$101.40	$290.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $90.95 / $164.29	Professional		$56.28	$90.95	$164.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.65 / $252.14 / $460.02	Professional		$138.65	$252.14	$460.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $101.68 / $185.16	Professional	26	$57.50	$101.68	$185.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.73 / $139.12 / $278.86	Professional	TC	$72.73	$139.12	$278.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.43 / $160.09 / $1,517.83	Professional		$122.43	$160.09	$1,517.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.92 / $91.20 / $286.05	Professional	26	$66.92	$91.20	$286.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $55.51 / $72.16 / $1,517.83	Professional	TC	$55.51	$72.16	$1,517.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.23 / $111.50 / $226.50	Professional		$60.23	$111.50	$226.50
United Facility/Professional Professional Modifier Low / Median / High Price $132.33 / $209.86 / $391.95	Professional		$132.33	$209.86	$391.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.55 / $83.88 / $164.36	Professional	26	$58.55	$83.88	$164.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.02 / $111.79 / $301.64	Professional	TC	$70.02	$111.79	$301.64