Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.81 / $107.81 / $189.05	Facility	26	$107.81	$107.81	$189.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.44 / $409.90 / $880.64	Professional		$350.44	$409.90	$880.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.04 / $124.23 / $304.14	Professional	26	$103.04	$124.23	$304.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $246.39 / $285.67 / $576.47	Professional	TC	$246.39	$285.67	$576.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.72 / $478.44 / $945.33	Professional		$332.72	$478.44	$945.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.38 / $160.72 / $285.02	Professional	26	$103.38	$160.72	$285.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.75 / $340.95 / $673.68	Professional	TC	$234.75	$340.95	$673.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.30 / $571.89 / $862.58	Professional		$352.30	$571.89	$862.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.13 / $181.27 / $297.62	Professional	26	$122.13	$181.27	$297.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.63 / $378.68 / $596.15	Professional	TC	$227.63	$378.68	$596.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $330.49 / $429.64 / $1,246.00	Professional		$330.49	$429.64	$1,246.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.08 / $132.69 / $461.02	Professional	26	$102.08	$132.69	$461.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $228.41 / $296.93 / $784.98	Professional	TC	$228.41	$296.93	$784.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.45 / $335.95 / $548.61	Professional		$169.45	$335.95	$548.61
United Facility/Professional Professional Modifier Low / Median / High Price $320.39 / $463.54 / $756.92	Professional		$320.39	$463.54	$756.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.07 / $158.11 / $274.76	Professional	26	$111.07	$158.11	$274.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.87 / $313.57 / $569.53	Professional	TC	$216.87	$313.57	$569.53