Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.75 / $63.84 / $179.80	Facility	26	$34.75	$63.84	$179.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.40 / $270.60 / $809.06	Professional		$221.40	$270.60	$809.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.01 / $57.33 / $116.22	Professional	26	$34.01	$57.33	$116.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $188.81 / $229.93 / $607.05	Professional	TC	$188.81	$229.93	$607.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.08 / $195.08 / $195.58	Professional		$195.08	$195.08	$195.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.52 / $56.34 / $71.73	Professional	26	$33.52	$56.34	$71.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.85 / $317.54 / $628.80	Professional		$221.85	$317.54	$628.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.11 / $53.86 / $92.29	Professional	26	$36.11	$53.86	$92.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $176.81 / $265.45 / $520.74	Professional	TC	$176.81	$265.45	$520.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.26 / $436.48 / $523.73	Professional		$87.26	$436.48	$523.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.50 / $393.22 / $692.74	Professional		$246.50	$393.22	$692.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.57 / $72.59 / $108.50	Professional	26	$40.57	$72.59	$108.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.37 / $339.26 / $584.24	Professional	TC	$183.37	$339.26	$584.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.42 / $448.64 / $669.41	Professional		$281.42	$448.64	$669.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.49 / $67.73 / $122.20	Professional	26	$42.49	$67.73	$122.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $238.93 / $380.90 / $568.33	Professional	TC	$238.93	$380.90	$568.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.39 / $327.32 / $615.46	Professional		$57.39	$327.32	$615.46
United Facility/Professional Professional Modifier Low / Median / High Price $238.95 / $336.44 / $626.82	Professional		$238.95	$336.44	$626.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.40 / $52.37 / $95.72	Professional	26	$39.40	$52.37	$95.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.61 / $280.23 / $536.17	Professional	TC	$179.61	$280.23	$536.17