Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.18 / $74.51 / $332.86	Facility	26	$65.18	$74.51	$332.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.76 / $498.46 / $1,285.72	Professional		$354.76	$498.46	$1,285.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $78.04 / $209.05	Professional	26	$64.09	$78.04	$209.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.63 / $414.12 / $941.36	Professional	TC	$290.63	$414.12	$941.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $312.88 / $552.14 / $758.05	Professional		$312.88	$552.14	$758.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.67 / $122.99 / $134.21	Professional	26	$62.67	$122.99	$134.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $402.14 / $402.14 / $402.14	Professional	TC	$402.14	$402.14	$402.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $367.47 / $549.32 / $1,011.10	Professional		$367.47	$549.32	$1,011.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.78 / $97.25 / $174.26	Professional	26	$66.78	$97.25	$174.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $302.39 / $460.16 / $836.84	Professional	TC	$302.39	$460.16	$836.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.69 / $675.45 / $838.15	Professional		$162.69	$675.45	$838.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.96 / $777.26 / $1,209.92	Professional		$423.96	$777.26	$1,209.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.18 / $133.32 / $204.06	Professional	26	$79.18	$133.32	$204.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $342.19 / $637.46 / $1,020.63	Professional	TC	$342.19	$637.46	$1,020.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $368.09 / $449.13 / $1,068.33	Professional		$368.09	$449.13	$1,068.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $79.52 / $126.77 / $379.13	Professional	26	$79.52	$126.77	$379.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $368.09 / $379.13 / $879.19	Professional	TC	$368.09	$379.13	$879.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.84 / $483.86 / $660.72	Professional		$101.84	$483.86	$660.72
United Facility/Professional Professional Modifier Low / Median / High Price $468.53 / $690.25 / $1,129.18	Professional		$468.53	$690.25	$1,129.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.45 / $124.69 / $195.68	Professional	26	$80.45	$124.69	$195.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $385.03 / $562.22 / $934.57	Professional	TC	$385.03	$562.22	$934.57