Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $199.53	Facility	26	$173.78	$173.78	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $346.74 / $758.58	Professional		$263.03	$346.74	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $208.93 / $467.74	Professional	26	$169.82	$208.93	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $117.49 / $208.93	Professional	TC	$93.33	$117.49	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $346.74 / $524.81	Professional		$269.15	$346.74	$524.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $213.80 / $331.13	Professional	26	$165.96	$213.80	$331.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $524.81	Professional		$275.42	$338.84	$524.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $213.80 / $323.59	Professional	26	$173.78	$213.80	$323.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $204.17	Professional	TC	$102.33	$128.82	$204.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $234.42 / $407.38	Professional		$114.82	$234.42	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $724.44	Professional		$309.03	$426.58	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $263.03 / $467.74	Professional	26	$194.98	$263.03	$467.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $154.88 / $269.15	Professional	TC	$104.71	$154.88	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $398.11 / $1,071.52	Professional		$316.23	$398.11	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $245.47 / $691.83	Professional	26	$199.53	$245.47	$691.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $147.91 / $416.87	Professional	TC	$120.23	$147.91	$416.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $288.40 / $562.34	Professional		$123.03	$288.40	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $741.31	Professional		$281.84	$407.38	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $257.04 / $457.09	Professional	26	$181.97	$257.04	$457.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $158.49 / $269.15	Professional	TC	$102.33	$158.49	$269.15