Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.46 / $69.51 / $198.12	Facility	26	$51.46	$69.51	$198.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.79 / $336.79 / $748.69	Professional		$250.79	$336.79	$748.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.46 / $84.95 / $190.23	Professional	26	$51.46	$84.95	$190.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.58 / $219.43 / $455.52	Professional	TC	$178.58	$219.43	$455.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.41 / $391.36 / $468.77	Professional		$193.41	$391.36	$468.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.59 / $82.74 / $100.66	Professional	26	$43.59	$82.74	$100.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $150.54 / $338.28 / $370.93	Professional	TC	$150.54	$338.28	$370.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.24 / $366.88 / $748.04	Professional		$227.24	$366.88	$748.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $90.25 / $168.23	Professional	26	$48.06	$90.25	$168.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.39 / $278.33 / $574.83	Professional	TC	$165.39	$278.33	$574.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.21 / $202.44 / $351.23	Professional		$54.21	$202.44	$351.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.58 / $62.58 / $101.47	Facility	26	$62.58	$62.58	$101.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.58 / $417.09 / $739.79	Professional		$270.58	$417.09	$739.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.35 / $96.24 / $165.53	Professional	26	$58.35	$96.24	$165.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.26 / $315.36 / $585.40	Professional	TC	$212.26	$315.36	$585.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $252.49 / $363.59 / $873.36	Professional		$252.49	$363.59	$873.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.97 / $79.05 / $245.00	Professional	26	$57.97	$79.05	$245.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $219.77 / $287.70 / $659.00	Professional	TC	$219.77	$287.70	$659.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.30 / $284.51 / $464.07	Professional		$74.30	$284.51	$464.07
United Facility/Professional Professional Modifier Low / Median / High Price $282.08 / $405.12 / $685.28	Professional		$282.08	$405.12	$685.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.79 / $94.86 / $160.81	Professional	26	$58.79	$94.86	$160.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.51 / $343.50 / $616.02	Professional	TC	$221.51	$343.50	$616.02