Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.18 / $139.31 / $222.81	Facility	26	$122.18	$139.31	$222.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.40 / $240.87 / $448.94	Professional		$198.40	$240.87	$448.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.34 / $138.50 / $280.79	Professional	26	$120.34	$138.50	$280.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.01 / $92.39 / $173.29	Professional	TC	$79.01	$92.39	$173.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.84 / $282.39 / $377.40	Professional		$194.84	$282.39	$377.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $151.28 / $186.76 / $230.56	Professional	26	$151.28	$186.76	$230.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.52 / $264.02 / $457.56	Professional		$155.52	$264.02	$457.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.01 / $151.75 / $266.25	Professional	26	$95.01	$151.75	$266.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.78 / $104.48 / $192.28	Professional	TC	$65.78	$104.48	$192.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $163.81 / $298.89	Professional		$84.65	$163.81	$298.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $288.81 / $489.94	Professional		$117.60	$288.81	$489.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $136.82 / $180.82 / $304.11	Professional	26	$136.82	$180.82	$304.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.26 / $124.11 / $212.49	Professional	TC	$92.26	$124.11	$212.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $262.11 / $1,481.20	Professional		$221.78	$262.11	$1,481.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $137.66 / $162.69 / $864.63	Professional	26	$137.66	$162.69	$864.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $84.12 / $99.41 / $616.50	Professional	TC	$84.12	$99.41	$616.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.94 / $189.40 / $359.82	Professional		$87.94	$189.40	$359.82
United Facility/Professional Professional Modifier Low / Median / High Price $210.71 / $314.81 / $524.67	Professional		$210.71	$314.81	$524.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.78 / $192.36 / $334.48	Professional	26	$127.78	$192.36	$334.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.44 / $129.30 / $213.02	Professional	TC	$83.44	$129.30	$213.02