Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.06 / $45.14 / $153.06	Facility	26	$30.06	$45.14	$153.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.59 / $304.32 / $701.14	Professional		$241.59	$304.32	$701.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $52.36 / $101.61	Professional	26	$30.06	$52.36	$101.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.45 / $270.12 / $625.73	Professional	TC	$213.45	$270.12	$625.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.86 / $213.86 / $213.86	Professional		$213.86	$213.86	$213.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.04 / $48.80 / $56.93	Professional	26	$29.04	$48.80	$56.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.41 / $383.68 / $692.60	Professional		$281.41	$383.68	$692.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $42.21 / $80.61	Professional	26	$30.70	$42.21	$80.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $247.52 / $342.44 / $611.99	Professional	TC	$247.52	$342.44	$611.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.66 / $497.25 / $572.91	Professional		$75.66	$497.25	$572.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.98 / $563.28 / $856.10	Professional		$331.98	$563.28	$856.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.20 / $59.78 / $94.84	Professional	26	$37.20	$59.78	$94.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $294.60 / $490.81 / $774.75	Professional	TC	$294.60	$490.81	$774.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.08 / $492.73 / $1,799.00	Professional		$309.08	$492.73	$1,799.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $58.68 / $197.89	Professional	26	$36.81	$58.68	$197.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $272.27 / $434.05 / $1,601.11	Professional	TC	$272.27	$434.05	$1,601.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.82 / $372.95 / $604.46	Professional		$49.82	$372.95	$604.46
United Facility/Professional Professional Modifier Low / Median / High Price $304.67 / $409.39 / $741.15	Professional		$304.67	$409.39	$741.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.09 / $45.72 / $81.48	Professional	26	$34.09	$45.72	$81.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.62 / $373.08 / $659.66	Professional	TC	$281.62	$373.08	$659.66