Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $136.86 / $265.99	Facility	26	$55.00	$136.86	$265.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.38 / $275.00 / $742.29	Professional		$231.38	$275.00	$742.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $69.00 / $183.36	Professional	26	$55.00	$69.00	$183.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.00 / $220.00 / $553.85	Professional	TC	$158.00	$220.00	$553.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $184.33 / $184.33 / $184.33	Professional		$184.33	$184.33	$184.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $98.33 / $107.27	Professional	26	$48.65	$98.33	$107.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.42 / $362.21 / $682.34	Professional		$213.42	$362.21	$682.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.35 / $85.46 / $169.90	Professional	26	$57.35	$85.46	$169.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.41 / $269.23 / $512.92	Professional	TC	$155.41	$269.23	$512.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.11 / $474.45 / $790.81	Professional		$273.11	$474.45	$790.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.31 / $108.34 / $180.86	Professional	26	$63.31	$108.34	$180.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.52 / $350.70 / $648.87	Professional	TC	$207.52	$350.70	$648.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.19 / $413.08 / $1,156.95	Professional		$227.19	$413.08	$1,156.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.56 / $104.15 / $253.34	Professional	26	$63.56	$104.15	$253.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $163.63 / $297.50 / $964.65	Professional	TC	$163.63	$297.50	$964.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.63 / $224.62 / $356.68	Professional		$86.63	$224.62	$356.68
United Facility/Professional Professional Modifier Low / Median / High Price $238.96 / $410.48 / $698.51	Professional		$238.96	$410.48	$698.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.37 / $89.58 / $148.88	Professional	26	$61.37	$89.58	$148.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.25 / $304.64 / $537.02	Professional	TC	$168.25	$304.64	$537.02