Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.60 / $108.06 / $484.39	Facility	26	$94.60	$108.06	$484.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.56 / $475.00 / $1,032.08	Professional		$293.56	$475.00	$1,032.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.70 / $146.19 / $322.00	Professional	26	$92.70	$146.19	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.86 / $245.69 / $515.69	Professional	TC	$200.86	$245.69	$515.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $258.97 / $346.02 / $624.97	Professional		$258.97	$346.02	$624.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.16 / $154.25 / $196.63	Professional	26	$89.16	$154.25	$196.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.02 / $468.00 / $979.00	Professional		$339.02	$468.00	$979.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.06 / $129.33 / $297.33	Professional	26	$104.06	$129.33	$297.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.87 / $314.08 / $678.49	Professional	TC	$237.87	$314.08	$678.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.31 / $253.59 / $463.29	Professional		$111.31	$253.59	$463.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $376.81 / $635.88 / $1,062.06	Professional		$376.81	$635.88	$1,062.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.32 / $176.60 / $326.01	Professional	26	$108.32	$176.60	$326.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.07 / $438.28 / $736.06	Professional	TC	$254.07	$438.28	$736.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $370.28 / $590.29 / $2,223.00	Professional		$370.28	$590.29	$2,223.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $116.50 / $152.51 / $450.68	Professional	26	$116.50	$152.51	$450.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $253.78 / $332.22 / $981.78	Professional	TC	$253.78	$332.22	$981.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.11 / $347.56 / $622.75	Professional		$151.11	$347.56	$622.75
United Facility/Professional Professional Modifier Low / Median / High Price $377.20 / $706.54 / $1,277.35	Professional		$377.20	$706.54	$1,277.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $131.10 / $257.89	Professional	26	$87.09	$131.10	$257.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.23 / $542.67 / $1,144.31	Professional	TC	$267.23	$542.67	$1,144.31