Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $467.74 / $1,023.29	Facility	26	$190.55	$467.74	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $616.60 / $1,202.26	Professional		$380.19	$616.60	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $338.84 / $602.56	Professional	26	$190.55	$338.84	$602.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $281.84 / $630.96	Professional	TC	$177.83	$281.84	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $602.56	Professional		$363.08	$457.09	$602.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $239.88 / $416.87	Professional	26	$173.78	$239.88	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $602.56 / $912.01	Professional		$457.09	$602.56	$912.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $275.42 / $446.68	Professional	26	$208.93	$275.42	$446.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $331.13 / $489.78	Professional	TC	$234.42	$331.13	$489.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $501.19 / $1,000.00	Professional		$295.12	$501.19	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $758.58 / $1,380.38	Professional		$489.78	$758.58	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $354.81 / $691.83	Professional	26	$229.09	$354.81	$691.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $398.11 / $724.44	Professional	TC	$245.47	$398.11	$724.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $630.96 / $1,659.59	Professional		$524.81	$630.96	$1,659.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $295.12 / $776.25	Professional	26	$251.19	$295.12	$776.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $891.25	Professional	TC	$281.84	$331.13	$891.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $363.08 / $758.58	Professional		$316.23	$363.08	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $602.56 / $1,202.26	Professional		$457.09	$602.56	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $275.42 / $562.34	Professional	26	$208.93	$275.42	$562.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $316.23 / $645.65	Professional	TC	$245.47	$316.23	$645.65