Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.44 / $117.96 / $335.53	Professional		$82.44	$117.96	$335.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $72.11 / $452.76	Professional	26	$34.46	$72.11	$452.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.94 / $73.48 / $163.40	Professional	TC	$52.94	$73.48	$163.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $51.43 / $51.43	Professional		$51.43	$51.43	$51.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.69 / $45.49 / $77.26	Professional	26	$19.69	$45.49	$77.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $94.83 / $281.20	Professional		$60.59	$94.83	$281.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.33 / $36.60 / $104.19	Professional	26	$22.33	$36.60	$104.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.46 / $58.23 / $179.42	Professional	TC	$39.46	$58.23	$179.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $71.64 / $126.08	Professional		$39.53	$71.64	$126.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.09 / $111.17 / $321.52	Professional		$62.09	$111.17	$321.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $40.99 / $121.34	Professional	26	$21.51	$40.99	$121.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.52 / $56.50 / $214.91	Professional	TC	$38.52	$56.50	$214.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.87 / $168.86 / $968.21	Professional		$100.87	$168.86	$968.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $60.94 / $342.94	Professional	26	$36.40	$60.94	$342.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $64.48 / $107.93 / $625.27	Professional	TC	$64.48	$107.93	$625.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.29 / $105.37 / $192.84	Professional		$45.29	$105.37	$192.84
United Facility/Professional Professional Modifier Low / Median / High Price $77.41 / $144.97 / $287.27	Professional		$77.41	$144.97	$287.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.89 / $56.06 / $110.26	Professional	26	$27.89	$56.06	$110.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.49 / $93.17 / $193.73	Professional	TC	$49.49	$93.17	$193.73