Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $1,258.93 / $2,511.89 / $6,456.54	Facility	TC	$1,258.93	$2,511.89	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $691.83	Professional		$181.97	$269.15	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $239.88 / $831.76	Professional	26	$74.13	$239.88	$831.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $169.82 / $512.86	Professional	TC	$109.65	$169.82	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $489.78	Professional		$125.89	$257.04	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $95.50 / $141.25	Professional	26	$37.15	$95.50	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	TC	$354.81	$354.81	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $251.19 / $501.19	Professional		$107.15	$251.19	$501.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $104.71 / $186.21	Professional	26	$35.48	$104.71	$186.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $120.23 / $338.84	Professional	TC	$72.44	$120.23	$338.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $257.04 / $524.81	Facility		$107.15	$257.04	$524.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $218.78 / $346.74	Professional		$89.13	$218.78	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $758.58	Professional		$102.33	$165.96	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $77.62 / $208.93	Professional	26	$38.90	$77.62	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $117.49 / $549.54	Professional	TC	$58.88	$117.49	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $2,238.72	Professional		$251.19	$426.58	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $645.65	Professional	26	$69.18	$117.49	$645.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $309.03 / $1,621.81	Professional	TC	$186.21	$309.03	$1,621.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $257.04 / $512.86	Professional		$81.28	$257.04	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $87.10 / $213.80	Facility		$38.02	$87.10	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $251.19 / $616.60	Professional		$158.49	$251.19	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $87.10 / $177.83	Professional	26	$50.12	$87.10	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $173.78 / $436.52	Professional	TC	$104.71	$173.78	$436.52