Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $398.11 / $1,000.00	Professional		$281.84	$398.11	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $281.84 / $741.31	Professional	26	$107.15	$281.84	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $234.42 / $537.03	Professional	TC	$151.36	$234.42	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $151.36 / $257.04	Professional	26	$64.57	$151.36	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $354.81 / $758.58	Professional		$162.18	$354.81	$758.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $169.82 / $295.12	Professional	26	$61.66	$169.82	$295.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $162.18 / $478.63	Professional	TC	$102.33	$162.18	$478.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $309.03 / $524.81	Professional		$158.49	$309.03	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $1,122.02	Professional		$151.36	$234.42	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $131.83 / $371.54	Professional	26	$67.61	$131.83	$371.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $162.18 / $758.58	Professional	TC	$79.43	$162.18	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $630.96 / $3,467.37	Professional		$380.19	$630.96	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $204.17 / $1,148.15	Professional	26	$123.03	$204.17	$1,148.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $426.58 / $2,290.87	Professional	TC	$257.04	$426.58	$2,290.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $389.05 / $776.25	Professional		$141.25	$389.05	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $933.25	Professional		$239.88	$380.19	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $338.84	Professional	26	$89.13	$151.36	$338.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $245.47 / $602.56	Professional	TC	$144.54	$245.47	$602.56