Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $151.36 / $281.84	Facility	26	$54.95	$151.36	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $630.96	Professional		$173.78	$275.42	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $154.88	Professional	26	$52.48	$72.44	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $213.80 / $371.54	Professional	TC	$120.23	$213.80	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $147.91 / $239.88	Professional		$60.26	$147.91	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $112.20	Professional	26	$44.67	$69.18	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Professional	TC	$213.80	$213.80	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $323.59 / $575.44	Professional		$213.80	$323.59	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $85.11 / $151.36	Professional	26	$56.23	$85.11	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $234.42 / $446.68	Professional	TC	$144.54	$234.42	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $398.11 / $707.95	Professional		$190.55	$398.11	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $97.72 / $165.96	Professional	26	$56.23	$97.72	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $281.84 / $562.34	Professional	TC	$134.90	$281.84	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $245.47 / $954.99	Professional		$186.21	$245.47	$954.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $213.80	Professional	26	$58.88	$79.43	$213.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $165.96 / $912.01	Professional	TC	$128.82	$165.96	$912.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $169.82 / $309.03	Professional		$61.66	$169.82	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $331.13 / $588.84	Professional		$190.55	$331.13	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $141.25	Professional	26	$58.88	$79.43	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $234.42 / $446.68	Professional	TC	$128.82	$234.42	$446.68