Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $281.84 / $316.23	Facility	26	$269.15	$281.84	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,202.26 / $2,398.83	Professional		$977.24	$1,202.26	$2,398.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $354.81 / $741.31	Professional	26	$275.42	$354.81	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $870.96 / $1,698.24	Professional	TC	$724.44	$870.96	$1,698.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,548.82	Professional		$1,000.00	$1,000.00	$1,548.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $354.81 / $524.81	Professional	26	$269.15	$354.81	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $2,344.23	Professional		$1,096.48	$1,862.09	$2,344.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $575.44 / $707.95	Professional	26	$309.03	$575.44	$707.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $1,318.26 / $1,659.59	Professional	TC	$724.44	$1,318.26	$1,659.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $812.83 / $2,089.30	Professional		$363.08	$812.83	$2,089.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,737.80 / $3,090.30	Professional		$1,202.26	$1,737.80	$3,090.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $363.08 / $501.19 / $912.01	Professional	26	$363.08	$501.19	$912.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $831.76 / $1,258.93 / $2,137.96	Professional	TC	$831.76	$1,258.93	$2,137.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $5,623.41	Professional		$1,174.90	$1,445.44	$5,623.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $416.87 / $4,265.80	Professional	26	$338.84	$416.87	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $831.76 / $1,023.29 / $4,265.80	Professional	TC	$831.76	$1,023.29	$4,265.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,548.82 / $3,019.95	Professional		$1,047.13	$1,548.82	$3,019.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $467.74 / $870.96	Professional	26	$309.03	$467.74	$870.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $1,047.13 / $2,137.96	Professional	TC	$741.31	$1,047.13	$2,137.96