Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $130.57 / $267.47	Facility	26	$55.00	$130.57	$267.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.16 / $275.00 / $709.73	Professional		$188.16	$275.00	$709.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $64.51 / $155.74	Professional	26	$55.00	$64.51	$155.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.78 / $220.00 / $540.41	Professional	TC	$127.78	$220.00	$540.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.28 / $139.28 / $147.60	Professional		$139.28	$139.28	$147.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.08 / $67.34 / $104.19	Professional	26	$50.08	$67.34	$104.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $213.48 / $213.48 / $213.48	Professional	TC	$213.48	$213.48	$213.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.89 / $303.60 / $612.47	Professional		$181.89	$303.60	$612.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.35 / $79.23 / $168.71	Professional	26	$57.35	$79.23	$168.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.53 / $206.40 / $450.53	Professional	TC	$124.53	$206.40	$450.53
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 $201.24 / $422.70 / $739.60	Professional		$201.24	$422.70	$739.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.60 / $105.95 / $179.71	Professional	26	$61.60	$105.95	$179.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.83 / $297.58 / $593.94	Professional	TC	$139.83	$297.58	$593.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.17 / $362.12 / $1,080.90	Professional		$199.17	$362.12	$1,080.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.56 / $102.07 / $222.61	Professional	26	$63.56	$102.07	$222.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $135.61 / $246.56 / $919.99	Professional	TC	$135.61	$246.56	$919.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $186.15 / $325.91	Professional		$83.56	$186.15	$325.91
United Facility/Professional Professional Modifier Low / Median / High Price $200.59 / $331.65 / $623.60	Professional		$200.59	$331.65	$623.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $90.12 / $142.63	Professional	26	$61.31	$90.12	$142.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.82 / $249.55 / $453.70	Professional	TC	$138.82	$249.55	$453.70