Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $120.23 / $269.15	Facility	26	$83.18	$120.23	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $426.58 / $741.31	Professional		$234.42	$426.58	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $165.96	Professional	26	$57.54	$85.11	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $562.34	Professional	TC	$177.83	$302.00	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	26	$42.66	$42.66	$42.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $512.86 / $812.83	Professional		$269.15	$512.86	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $74.13 / $120.23	Professional	26	$50.12	$74.13	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $416.87 / $724.44	Professional	TC	$213.80	$416.87	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $549.54 / $1,023.29	Professional		$269.15	$549.54	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $169.82	Professional	26	$52.48	$85.11	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $436.52 / $891.25	Professional	TC	$218.78	$436.52	$891.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $302.00 / $1,412.54	Professional		$229.09	$302.00	$1,412.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $199.53	Professional	26	$56.23	$75.86	$199.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $1,318.26	Professional	TC	$173.78	$229.09	$1,318.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $190.55 / $407.38	Professional		$57.54	$190.55	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $457.09 / $776.25	Professional		$234.42	$457.09	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $128.82	Professional	26	$53.70	$67.61	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $354.81 / $676.08	Professional	TC	$177.83	$354.81	$676.08