Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $189.68 / $442.87 / $1,026.55	Facility	26	$189.68	$442.87	$1,026.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $359.60 / $504.96 / $2,039.73	Professional		$359.60	$504.96	$2,039.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $189.68 / $292.14 / $611.91	Professional	26	$189.68	$292.14	$611.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $188.14 / $306.66 / $1,153.00	Professional	TC	$188.14	$306.66	$1,153.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $430.79 / $434.83 / $646.57	Professional		$430.79	$434.83	$646.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $212.07 / $328.71 / $409.86	Professional	26	$212.07	$328.71	$409.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $448.35 / $746.15 / $1,800.38	Professional		$448.35	$746.15	$1,800.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $206.61 / $287.12 / $574.77	Professional	26	$206.61	$287.12	$574.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $233.99 / $403.01 / $1,439.90	Professional	TC	$233.99	$403.01	$1,439.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $222.10 / $464.69 / $996.08	Professional		$222.10	$464.69	$996.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.01 / $1,017.03 / $2,253.59	Professional		$539.01	$1,017.03	$2,253.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $217.81 / $390.28 / $611.25	Professional	26	$217.81	$390.28	$611.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.29 / $590.12 / $936.28	Professional	TC	$281.29	$590.12	$936.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $519.15 / $827.61 / $3,488.54	Professional		$519.15	$827.61	$3,488.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $242.84 / $387.12 / $612.17	Professional	26	$242.84	$387.12	$612.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $276.32 / $440.50 / $3,488.54	Professional	TC	$276.32	$440.50	$3,488.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $319.80 / $413.06 / $873.11	Professional		$319.80	$413.06	$873.11
United Facility/Professional Professional Modifier Low / Median / High Price $483.74 / $770.86 / $1,457.19	Professional		$483.74	$770.86	$1,457.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $209.03 / $285.83 / $511.84	Professional	26	$209.03	$285.83	$511.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.94 / $424.13 / $1,028.63	Professional	TC	$239.94	$424.13	$1,028.63