Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.21 / $146.21 / $264.38	Facility	26	$146.21	$146.21	$264.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.86 / $272.00 / $532.64	Professional		$233.86	$272.00	$532.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $160.60 / $308.66	Professional	26	$144.25	$160.60	$308.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.48 / $104.53 / $190.21	Professional	TC	$85.48	$104.53	$190.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.37 / $340.83 / $441.30	Professional		$223.37	$340.83	$441.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $181.20 / $252.58 / $275.37	Professional	26	$181.20	$252.58	$275.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.86 / $296.01 / $535.74	Professional		$181.86	$296.01	$535.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.48 / $180.30 / $319.13	Professional	26	$113.48	$180.30	$319.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.43 / $114.73 / $217.54	Professional	TC	$69.43	$114.73	$217.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $94.14 / $196.14 / $348.90	Professional		$94.14	$196.14	$348.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $334.57 / $571.19	Professional		$117.60	$334.57	$571.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $164.10 / $215.46 / $364.10	Professional	26	$164.10	$215.46	$364.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.86 / $135.35 / $238.51	Professional	TC	$98.86	$135.35	$238.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.57 / $305.58 / $1,713.81	Professional		$258.57	$305.58	$1,713.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $164.81 / $194.78 / $1,034.71	Professional	26	$164.81	$194.78	$1,034.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.74 / $110.79 / $679.10	Professional	TC	$93.74	$110.79	$679.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $224.45 / $410.59	Professional		$98.00	$224.45	$410.59
United Facility/Professional Professional Modifier Low / Median / High Price $246.33 / $374.95 / $640.19	Professional		$246.33	$374.95	$640.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $152.27 / $229.22 / $390.45	Professional	26	$152.27	$229.22	$390.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.74 / $142.82 / $242.52	Professional	TC	$90.74	$142.82	$242.52