Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $190.55 / $309.03	Facility	26	$75.86	$190.55	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $1,122.02	Professional		$218.78	$346.74	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $117.49 / $380.19	Professional	26	$77.62	$117.49	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $173.78 / $354.81	Professional	TC	$138.04	$173.78	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $371.54	Professional		$194.98	$234.42	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $81.28 / $100.00	Professional	26	$77.62	$81.28	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $436.52 / $630.96	Professional		$263.03	$436.52	$630.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $162.18 / $199.53	Professional	26	$93.33	$162.18	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $338.84	Professional	TC	$169.82	$281.84	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $158.49 / $281.84	Professional		$83.18	$158.49	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $630.96	Professional		$239.88	$354.81	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $125.89 / $218.78	Professional	26	$89.13	$125.89	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $208.93 / $363.08	Professional	TC	$151.36	$208.93	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $977.24	Professional		$234.42	$309.03	$977.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $309.03	Professional	26	$81.28	$107.15	$309.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $676.08	Professional	TC	$154.88	$199.53	$676.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $323.59 / $524.81	Professional		$151.36	$323.59	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $309.03 / $575.44	Professional		$229.09	$309.03	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $114.82 / $213.80	Professional	26	$81.28	$114.82	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $199.53 / $363.08	Professional	TC	$141.25	$199.53	$363.08