Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.77 / $673.48 / $1,579.20	Facility		$186.77	$673.48	$1,579.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.56 / $50.28 / $136.91	Facility	26	$35.56	$50.28	$136.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $230.23 / $436.93	Professional		$170.83	$230.23	$436.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.84 / $41.95 / $91.30	Professional	26	$34.84	$41.95	$91.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.37 / $162.57 / $335.18	Professional	TC	$139.37	$162.57	$335.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.15 / $274.74 / $323.45	Professional		$134.15	$274.74	$323.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $57.46 / $67.81	Professional	26	$28.62	$57.46	$67.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $225.28 / $225.28 / $225.28	Professional	TC	$225.28	$225.28	$225.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.58 / $448.49 / $529.62	Facility		$251.58	$448.49	$529.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.79 / $245.44 / $486.37	Professional		$156.79	$245.44	$486.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $46.12 / $85.92	Professional	26	$30.73	$46.12	$85.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.17 / $195.69 / $392.37	Professional	TC	$123.17	$195.69	$392.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.28 / $169.88 / $244.70	Facility		$47.28	$169.88	$244.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.75 / $138.63 / $240.53	Professional		$37.75	$138.63	$240.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.36 / $320.58 / $400.53	Facility		$215.36	$320.58	$400.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.31 / $43.31 / $69.41	Facility	26	$43.31	$43.31	$69.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.33 / $270.26 / $480.31	Professional		$185.33	$270.26	$480.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $51.40 / $86.94	Professional	26	$34.22	$51.40	$86.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.32 / $218.62 / $401.01	Professional	TC	$142.32	$218.62	$401.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $191.64 / $261.33 / $553.98	Professional		$191.64	$261.33	$553.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.09 / $52.29 / $108.52	Professional	26	$41.09	$52.29	$108.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $150.55 / $205.29 / $473.16	Professional	TC	$150.55	$205.29	$473.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.01 / $200.46 / $488.80	Professional		$53.01	$200.46	$488.80
United Facility/Professional Facility Modifier Low / Median / High Price $36.46 / $146.22 / $182.69	Facility		$36.46	$146.22	$182.69
United Facility/Professional Professional Modifier Low / Median / High Price $186.24 / $268.32 / $470.69	Professional		$186.24	$268.32	$470.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $50.33 / $97.89	Professional	26	$36.15	$50.33	$97.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.25 / $214.77 / $370.09	Professional	TC	$148.25	$214.77	$370.09