Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.11 / $67.31 / $158.99	Facility	26	$32.11	$67.31	$158.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.65 / $248.28 / $583.47	Professional		$191.65	$248.28	$583.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $47.07 / $96.22	Professional	26	$30.35	$47.07	$96.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $160.41 / $210.58 / $506.27	Professional	TC	$160.41	$210.58	$506.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.68 / $314.12 / $391.45	Professional		$232.68	$314.12	$391.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.25 / $59.29 / $67.16	Professional	26	$35.25	$59.29	$67.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.81 / $300.98 / $628.37	Professional		$184.81	$300.98	$628.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.93 / $45.84 / $95.49	Professional	26	$32.93	$45.84	$95.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $159.08 / $259.07 / $540.88	Professional	TC	$159.08	$259.07	$540.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $216.09 / $528.76	Professional		$36.79	$216.09	$528.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.08 / $329.56 / $697.70	Professional		$220.08	$329.56	$697.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $63.06 / $101.75	Professional	26	$35.46	$63.06	$101.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.86 / $291.41 / $627.07	Professional	TC	$179.86	$291.41	$627.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $285.52 / $389.36 / $519.14	Professional		$285.52	$389.36	$519.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $64.25 / $95.40	Professional	26	$40.29	$64.25	$95.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.22 / $334.40 / $452.25	Professional	TC	$245.22	$334.40	$452.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.41 / $336.34 / $480.20	Professional		$54.41	$336.34	$480.20
United Facility/Professional Professional Modifier Low / Median / High Price $198.38 / $311.06 / $708.00	Professional		$198.38	$311.06	$708.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $44.88 / $92.33	Professional	26	$32.39	$44.88	$92.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.68 / $266.35 / $535.62	Professional	TC	$143.68	$266.35	$535.62