Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.55 / $190.22 / $456.13	Facility	26	$90.55	$190.22	$456.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.86 / $197.12 / $807.40	Professional		$102.86	$197.12	$807.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.21 / $131.83 / $297.06	Professional	26	$88.21	$131.83	$297.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $42.03 / $239.44	Professional	TC	$19.80	$42.03	$239.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.66 / $135.34 / $225.74	Professional		$126.66	$135.34	$225.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.48 / $175.38 / $194.39	Professional	26	$85.48	$175.38	$194.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $225.51 / $739.37	Professional		$128.26	$225.51	$739.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.81 / $131.94 / $277.70	Professional	26	$94.81	$131.94	$277.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.50 / $55.57 / $577.30	Professional	TC	$26.50	$55.57	$577.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.34 / $105.34 / $309.00	Professional		$36.34	$105.34	$309.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $335.98 / $924.86	Professional		$148.94	$335.98	$924.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.82 / $180.68 / $320.41	Professional	26	$100.82	$180.68	$320.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $97.75 / $304.82	Professional	TC	$31.66	$97.75	$304.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.77 / $249.92 / $1,431.67	Professional		$156.77	$249.92	$1,431.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $115.17 / $183.60 / $281.35	Professional	26	$115.17	$183.60	$281.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.60 / $66.31 / $1,431.67	Professional	TC	$41.60	$66.31	$1,431.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.46 / $170.47 / $257.95	Professional		$54.46	$170.47	$257.95
United Facility/Professional Professional Modifier Low / Median / High Price $136.65 / $220.20 / $505.48	Professional		$136.65	$220.20	$505.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.93 / $128.87 / $242.84	Professional	26	$94.93	$128.87	$242.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.98 / $55.29 / $339.25	Professional	TC	$25.98	$55.29	$339.25