Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.98 / $141.62 / $350.65	Facility	26	$68.98	$141.62	$350.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.03 / $540.34 / $1,359.62	Professional		$362.03	$540.34	$1,359.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $98.90 / $211.68	Professional	26	$67.73	$98.90	$211.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $296.77 / $421.51 / $1,024.15	Professional	TC	$296.77	$421.51	$1,024.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $384.20 / $401.15 / $584.80	Professional		$384.20	$401.15	$584.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $119.68 / $149.22	Professional	26	$77.20	$119.68	$149.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.48 / $543.89 / $1,044.85	Professional		$368.48	$543.89	$1,044.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $100.26 / $210.63	Professional	26	$72.34	$100.26	$210.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.55 / $447.43 / $861.71	Professional	TC	$281.55	$447.43	$861.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $335.87 / $873.96	Professional		$80.90	$335.87	$873.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $429.39 / $769.26 / $1,294.66	Professional		$429.39	$769.26	$1,294.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.65 / $138.90 / $220.87	Professional	26	$77.65	$138.90	$220.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $355.29 / $673.92 / $1,091.31	Professional	TC	$355.29	$673.92	$1,091.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $469.56 / $640.30 / $885.41	Professional		$469.56	$640.30	$885.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $88.42 / $140.94 / $211.71	Professional	26	$88.42	$140.94	$211.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $381.14 / $519.74 / $885.41	Professional	TC	$381.14	$519.74	$885.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $119.05 / $530.70 / $789.71	Professional		$119.05	$530.70	$789.71
United Facility/Professional Professional Modifier Low / Median / High Price $402.27 / $619.29 / $1,081.04	Professional		$402.27	$619.29	$1,081.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.08 / $98.62 / $186.69	Professional	26	$72.08	$98.62	$186.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.26 / $516.65 / $899.65	Professional	TC	$331.26	$516.65	$899.65