Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.27 / $118.42 / $247.44	Facility	26	$64.27	$118.42	$247.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.61 / $214.53 / $509.22	Professional		$178.61	$214.53	$509.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.27 / $80.40 / $180.05	Professional	26	$64.27	$80.40	$180.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.78 / $131.40 / $280.44	Professional	TC	$112.78	$131.40	$280.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $423.94 / $423.94 / $423.94	Professional		$423.94	$423.94	$423.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.24 / $121.53 / $154.47	Professional	26	$84.24	$121.53	$154.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.12 / $279.25 / $589.02	Professional		$159.12	$279.25	$589.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.37 / $111.47 / $216.69	Professional	26	$63.37	$111.47	$216.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.49 / $165.55 / $370.73	Professional	TC	$89.49	$165.55	$370.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $127.26 / $227.08	Professional		$67.58	$127.26	$227.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.36 / $288.14 / $538.87	Professional		$176.36	$288.14	$538.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.48 / $109.76 / $188.63	Professional	26	$77.48	$109.76	$188.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.04 / $193.26 / $361.67	Professional	TC	$107.04	$193.26	$361.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.48 / $247.52 / $697.82	Professional		$194.48	$247.52	$697.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.01 / $98.19 / $232.70	Professional	26	$72.01	$98.19	$232.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $111.35 / $155.88 / $491.23	Professional	TC	$111.35	$155.88	$491.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.82 / $180.90 / $348.10	Professional		$104.82	$180.90	$348.10
United Facility/Professional Professional Modifier Low / Median / High Price $178.07 / $251.47 / $478.51	Professional		$178.07	$251.47	$478.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.31 / $99.87 / $182.49	Professional	26	$72.31	$99.87	$182.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.87 / $165.36 / $309.11	Professional	TC	$104.87	$165.36	$309.11