Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $134.90 / $338.84	Facility	26	$77.62	$134.90	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $1,071.52	Professional		$251.19	$426.58	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $112.20 / $263.03	Professional	26	$69.18	$112.20	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $302.00 / $616.60	Professional	TC	$181.97	$302.00	$616.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	26	$66.07	$66.07	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $524.81 / $851.14	Professional		$295.12	$524.81	$851.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $83.18 / $144.54	Professional	26	$56.23	$83.18	$144.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $426.58 / $741.31	Professional	TC	$213.80	$426.58	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $575.44 / $1,023.29	Professional		$302.00	$575.44	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $199.53	Professional	26	$57.54	$97.72	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $457.09 / $891.25	Professional	TC	$234.42	$457.09	$891.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $1,479.11	Professional		$251.19	$323.59	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $91.20 / $218.78	Professional	26	$69.18	$91.20	$218.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $234.42 / $1,318.26	Professional	TC	$177.83	$234.42	$1,318.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $194.98 / $446.68	Professional		$72.44	$194.98	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $831.76	Professional		$251.19	$467.74	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $81.28 / $162.18	Professional	26	$58.88	$81.28	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $371.54 / $691.83	Professional	TC	$181.97	$371.54	$691.83