Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.84 / $66.20 / $270.00	Facility	26	$52.84	$66.20	$270.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $319.55 / $428.31 / $896.62	Professional		$319.55	$428.31	$896.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $58.04 / $126.49	Professional	26	$51.32	$58.04	$126.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $370.27 / $686.43	Professional	TC	$281.79	$370.27	$686.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $399.06 / $567.29 / $812.07	Professional		$399.06	$567.29	$812.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.51 / $80.31 / $99.90	Professional	26	$63.51	$80.31	$99.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.39 / $484.21 / $910.24	Professional		$225.39	$484.21	$910.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.13 / $70.70 / $133.13	Professional	26	$41.13	$70.70	$133.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $156.44 / $422.66 / $798.37	Professional	TC	$156.44	$422.66	$798.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.62 / $441.63 / $662.32	Professional		$62.62	$441.63	$662.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.56 / $496.63 / $1,007.15	Professional		$228.56	$496.63	$1,007.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.16 / $77.34 / $130.75	Professional	26	$55.16	$77.34	$130.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.04 / $449.19 / $930.72	Professional	TC	$185.04	$449.19	$930.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $259.16 / $524.17 / $1,491.87	Professional		$259.16	$524.17	$1,491.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $69.95 / $183.77	Professional	26	$59.19	$69.95	$183.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $259.16 / $459.61 / $1,308.08	Professional	TC	$259.16	$459.61	$1,308.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.86 / $445.79 / $776.83	Professional		$58.86	$445.79	$776.83
United Facility/Professional Professional Modifier Low / Median / High Price $249.99 / $460.99 / $972.62	Professional		$249.99	$460.99	$972.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.55 / $77.93 / $141.88	Professional	26	$53.55	$77.93	$141.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.25 / $398.75 / $908.72	Professional	TC	$183.25	$398.75	$908.72