Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $178.83	Facility	26	$98.41	$98.41	$178.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.69 / $196.18 / $379.58	Professional		$166.69	$196.18	$379.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $108.25 / $226.91	Professional	26	$96.29	$108.25	$226.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.36 / $79.70 / $153.56	Professional	TC	$69.36	$79.70	$153.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $226.82 / $312.99	Professional		$159.56	$226.82	$312.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $100.14 / $144.56 / $184.57	Professional	26	$100.14	$144.56	$184.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.97 / $221.00 / $378.01	Professional		$128.97	$221.00	$378.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.06 / $121.65 / $213.38	Professional	26	$76.06	$121.65	$213.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.44 / $92.63 / $165.65	Professional	TC	$57.44	$92.63	$165.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $134.94 / $248.45	Professional		$74.98	$134.94	$248.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $239.51 / $409.54	Professional		$117.60	$239.51	$409.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.52 / $144.94 / $243.34	Professional	26	$109.52	$144.94	$243.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.37 / $107.92 / $184.65	Professional	TC	$80.37	$107.92	$184.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.70 / $218.28 / $1,234.48	Professional		$184.70	$218.28	$1,234.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $110.15 / $130.18 / $696.42	Professional	26	$110.15	$130.18	$696.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $88.10 / $538.00	Professional	TC	$74.55	$88.10	$538.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $153.36 / $299.39	Professional		$78.06	$153.36	$299.39
United Facility/Professional Professional Modifier Low / Median / High Price $182.27 / $273.49 / $454.06	Professional		$182.27	$273.49	$454.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.86 / $155.50 / $267.77	Professional	26	$102.86	$155.50	$267.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.12 / $113.59 / $186.29	Professional	TC	$75.12	$113.59	$186.29