Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $1,257.68 / $2,515.37 / $6,455.58	Facility	TC	$1,257.68	$2,515.37	$6,455.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.46 / $261.63 / $697.48	Professional		$182.46	$261.63	$697.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $104.04 / $716.55	Professional	26	$60.63	$104.04	$716.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.97 / $168.99 / $374.00	Professional	TC	$78.97	$168.99	$374.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.10 / $129.12 / $327.86	Professional		$126.10	$129.12	$327.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $96.12 / $141.22	Professional	26	$36.97	$96.12	$141.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $350.31 / $350.31 / $350.31	Professional	TC	$350.31	$350.31	$350.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $213.26 / $612.55	Professional		$108.00	$213.26	$612.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.14 / $86.90 / $188.68	Professional	26	$35.14	$86.90	$188.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.86 / $103.93 / $381.49	Professional	TC	$72.86	$103.93	$381.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.52 / $249.55 / $482.59	Facility		$103.52	$249.55	$482.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.27 / $201.08 / $309.94	Professional		$74.27	$201.08	$309.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.47 / $166.85 / $755.61	Professional		$101.47	$166.85	$755.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $78.29 / $208.66	Professional	26	$38.82	$78.29	$208.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.54 / $121.34 / $550.97	Professional	TC	$59.54	$121.34	$550.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $250.02 / $418.53 / $2,261.62	Professional		$250.02	$418.53	$2,261.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.04 / $115.57 / $649.87	Professional	26	$69.04	$115.57	$649.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $180.97 / $302.95 / $1,611.75	Professional	TC	$180.97	$302.95	$1,611.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.03 / $261.55 / $468.31	Professional		$85.03	$261.55	$468.31
United Facility/Professional Professional Modifier Low / Median / High Price $154.87 / $264.82 / $567.24	Professional		$154.87	$264.82	$567.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.57 / $86.55 / $173.24	Professional	26	$50.57	$86.55	$173.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.18 / $182.15 / $433.83	Professional	TC	$104.18	$182.15	$433.83