Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $707.95 / $1,584.89	Facility		$181.97	$707.95	$1,584.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $41.69 / $144.54	Facility	26	$35.48	$41.69	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $234.42 / $467.74	Professional		$162.18	$234.42	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.98 / $107.15	Professional	26	$34.67	$48.98	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $316.23	Professional	TC	$131.83	$165.96	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $181.97 / $323.59	Professional		$134.90	$181.97	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $70.79	Professional	26	$30.90	$39.81	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $109.65 / $123.03	Professional	TC	$109.65	$109.65	$123.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $446.68 / $524.81	Facility		$229.09	$446.68	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $398.11	Professional		$181.97	$257.04	$398.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $79.43	Professional	26	$33.11	$46.77	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $331.13	Professional	TC	$144.54	$213.80	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $181.97 / $269.15	Facility		$52.48	$181.97	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $144.54 / $218.78	Professional		$38.02	$144.54	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $363.08 / $426.58	Facility		$213.80	$363.08	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $478.63	Professional		$173.78	$263.03	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $89.13	Professional	26	$33.88	$48.98	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $389.05	Professional	TC	$141.25	$218.78	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $575.44	Professional		$181.97	$239.88	$575.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $109.65	Professional	26	$38.02	$50.12	$109.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $190.55 / $478.63	Professional	TC	$144.54	$190.55	$478.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $234.42 / $501.19	Professional		$54.95	$234.42	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $147.91 / $199.53	Facility		$36.31	$147.91	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $436.52	Professional		$181.97	$251.19	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $77.62	Professional	26	$34.67	$45.71	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $363.08	Professional	TC	$141.25	$213.80	$363.08