Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.67 / $348.53 / $1,153.07	Professional		$263.67	$348.53	$1,153.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.86 / $71.29 / $636.16	Professional	26	$42.86	$71.29	$636.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.25 / $290.89 / $849.46	Professional	TC	$133.25	$290.89	$849.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $662.61 / $662.61 / $662.61	Professional		$662.61	$662.61	$662.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $109.15 / $115.52	Professional	26	$29.82	$109.15	$115.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.04 / $167.04 / $874.28	Professional		$167.04	$167.04	$874.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $26.78 / $146.59	Professional	26	$26.78	$26.78	$146.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.26 / $140.26 / $722.21	Professional	TC	$140.26	$140.26	$722.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.16 / $314.88 / $416.28	Professional		$59.16	$314.88	$416.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.29 / $257.42 / $1,126.09	Professional		$107.29	$257.42	$1,126.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $43.92 / $165.73	Professional	26	$31.94	$43.92	$165.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.45 / $173.60 / $862.78	Professional	TC	$72.45	$173.60	$862.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.83 / $565.53 / $3,309.64	Professional		$337.83	$565.53	$3,309.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.43 / $91.12 / $503.43	Professional	26	$54.43	$91.12	$503.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $283.39 / $474.40 / $2,806.21	Professional	TC	$283.39	$474.40	$2,806.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $358.50 / $637.78	Professional		$67.61	$358.50	$637.78
United Facility/Professional Professional Modifier Low / Median / High Price $196.31 / $327.04 / $823.56	Professional		$196.31	$327.04	$823.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $67.45 / $160.07	Professional	26	$39.97	$67.45	$160.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.10 / $308.50 / $691.98	Professional	TC	$154.10	$308.50	$691.98