Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $218.78 / $478.63	Facility	26	$91.20	$218.78	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $741.31	Professional		$112.20	$194.98	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $162.18 / $275.42	Professional	26	$87.10	$162.18	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $34.67 / $125.89	Professional	TC	$19.95	$34.67	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $234.42	Professional		$107.15	$141.25	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $120.23 / $194.98	Professional	26	$83.18	$120.23	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $281.84 / $741.31	Professional		$138.04	$281.84	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $223.87	Professional	26	$100.00	$134.90	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $114.82 / $575.44	Professional	TC	$34.67	$114.82	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $141.25 / $316.23	Professional		$46.77	$141.25	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $338.84 / $933.25	Professional		$147.91	$338.84	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $173.78 / $316.23	Professional	26	$100.00	$173.78	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $87.10 / $446.68	Professional	TC	$31.62	$87.10	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $1,258.93	Professional		$162.18	$190.55	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $141.25 / $281.84	Professional	26	$117.49	$141.25	$281.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $51.29 / $1,258.93	Professional	TC	$43.65	$51.29	$1,258.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $151.36 / $234.42	Professional		$54.95	$151.36	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $239.88 / $524.81	Professional		$138.04	$239.88	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $128.82 / $263.03	Professional	26	$95.50	$128.82	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $57.54 / $407.38	Professional	TC	$26.92	$57.54	$407.38