Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.16 / $169.39 / $236.34	Professional		$92.16	$169.39	$236.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.44 / $22.34 / $51.71	Professional	26	$16.44	$22.34	$51.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.94 / $147.05 / $200.61	Professional	TC	$65.94	$147.05	$200.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.54 / $116.17 / $379.14	Professional		$64.54	$116.17	$379.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.29 / $25.02 / $79.20	Professional	26	$20.29	$25.02	$79.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.25 / $79.65 / $307.31	Professional	TC	$44.25	$79.65	$307.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $166.25 / $208.22	Professional		$21.48	$166.25	$208.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.30 / $180.29 / $485.76	Professional		$70.30	$180.29	$485.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $29.32 / $101.62	Professional	26	$11.69	$29.32	$101.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.82 / $90.14 / $402.34	Professional	TC	$49.82	$90.14	$402.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.45 / $283.66 / $1,595.50	Professional		$169.45	$283.66	$1,595.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $33.18 / $193.14	Professional	26	$19.82	$33.18	$193.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $149.63 / $250.47 / $1,402.36	Professional	TC	$149.63	$250.47	$1,402.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.74 / $178.87 / $318.02	Professional		$24.74	$178.87	$318.02
United Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $182.97 / $449.30	Professional		$109.58	$182.97	$449.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.54 / $32.46 / $64.08	Professional	26	$15.54	$32.46	$64.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.79 / $156.66 / $370.99	Professional	TC	$92.79	$156.66	$370.99