Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.50 / $41.74 / $188.70	Facility	26	$36.50	$41.74	$188.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.77 / $436.79 / $1,196.08	Professional		$324.77	$436.79	$1,196.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $64.80 / $115.97	Professional	26	$35.72	$64.80	$115.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.62 / $399.06 / $1,031.84	Professional	TC	$290.62	$399.06	$1,031.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $286.87 / $286.87 / $336.64	Professional		$286.87	$286.87	$336.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.47 / $59.13 / $75.31	Professional	26	$34.47	$59.13	$75.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $377.18 / $519.96 / $929.04	Professional		$377.18	$519.96	$929.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $50.88 / $96.96	Professional	26	$37.85	$50.88	$96.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $336.62 / $469.60 / $832.08	Professional	TC	$336.62	$469.60	$832.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $676.39 / $767.93	Professional		$91.54	$676.39	$767.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $454.31 / $762.59 / $1,165.34	Professional		$454.31	$762.59	$1,165.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.93 / $73.58 / $114.47	Professional	26	$44.93	$73.58	$114.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $409.12 / $670.09 / $1,053.60	Professional	TC	$409.12	$670.09	$1,053.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $414.90 / $661.42 / $1,907.00	Professional		$414.90	$661.42	$1,907.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.63 / $71.14 / $171.63	Professional	26	$44.63	$71.14	$171.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $370.28 / $590.29 / $1,735.37	Professional	TC	$370.28	$590.29	$1,735.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.30 / $502.97 / $815.92	Professional		$60.30	$502.97	$815.92
United Facility/Professional Professional Modifier Low / Median / High Price $433.19 / $568.19 / $1,001.10	Professional		$433.19	$568.19	$1,001.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.05 / $54.96 / $100.46	Professional	26	$41.05	$54.96	$100.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $387.85 / $507.79 / $900.64	Professional	TC	$387.85	$507.79	$900.64