Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.66 / $371.86 / $684.24	Professional		$277.66	$371.86	$684.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.51 / $178.44 / $705.76	Professional	26	$97.51	$178.44	$705.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.26 / $233.77 / $377.25	Professional	TC	$114.26	$233.77	$377.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $188.98 / $188.98 / $188.98	Professional		$188.98	$188.98	$188.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.15 / $169.39 / $248.87	Professional	26	$65.15	$169.39	$248.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.02 / $300.74 / $908.23	Professional		$164.02	$300.74	$908.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.35 / $148.76 / $332.54	Professional	26	$62.35	$148.76	$332.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.19 / $137.57 / $507.80	Professional	TC	$100.19	$137.57	$507.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $279.45 / $464.09	Professional		$131.16	$279.45	$464.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $237.85 / $1,127.97	Professional		$151.22	$237.85	$1,127.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.87 / $134.83 / $367.86	Professional	26	$66.87	$134.83	$367.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.00 / $164.79 / $765.69	Professional	TC	$79.00	$164.79	$765.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $373.22 / $624.77 / $3,442.34	Professional		$373.22	$624.77	$3,442.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.72 / $203.75 / $1,145.26	Professional	26	$121.72	$203.75	$1,145.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.51 / $378.93 / $2,297.16	Professional	TC	$251.51	$378.93	$2,297.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $149.84 / $388.44 / $698.60	Professional		$149.84	$388.44	$698.60
United Facility/Professional Professional Modifier Low / Median / High Price $239.79 / $414.16 / $862.90	Professional		$239.79	$414.16	$862.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.41 / $152.55 / $324.88	Professional	26	$88.41	$152.55	$324.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.19 / $249.30 / $628.65	Professional	TC	$145.19	$249.30	$628.65