Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $158.99 / $380.40	Facility	26	$85.00	$158.99	$380.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.57 / $475.00 / $1,205.45	Professional		$380.57	$475.00	$1,205.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $131.34 / $382.62	Professional	26	$85.00	$131.34	$382.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $289.68 / $340.00 / $985.40	Professional	TC	$289.68	$340.00	$985.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $260.33 / $275.08 / $631.15	Professional		$260.33	$275.08	$631.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.79 / $119.55 / $156.81	Professional	26	$69.79	$119.55	$156.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.76 / $602.69 / $1,387.71	Professional		$341.76	$602.69	$1,387.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.23 / $110.72 / $234.41	Professional	26	$69.23	$110.72	$234.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.58 / $484.95 / $1,238.64	Professional	TC	$260.58	$484.95	$1,238.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $439.44 / $923.63 / $1,879.54	Professional		$439.44	$923.63	$1,879.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.72 / $142.50 / $249.00	Professional	26	$82.72	$142.50	$249.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $336.61 / $794.16 / $1,565.40	Professional	TC	$336.61	$794.16	$1,565.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $373.95 / $679.90 / $2,467.23	Professional		$373.95	$679.90	$2,467.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $90.31 / $139.75 / $316.07	Professional	26	$90.31	$139.75	$316.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $283.62 / $515.67 / $2,467.23	Professional	TC	$283.62	$515.67	$2,467.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.05 / $371.39 / $626.17	Professional		$117.05	$371.39	$626.17
United Facility/Professional Professional Modifier Low / Median / High Price $384.02 / $790.42 / $1,297.77	Professional		$384.02	$790.42	$1,297.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.75 / $115.08 / $196.78	Professional	26	$81.75	$115.08	$196.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $299.41 / $617.24 / $1,070.46	Professional	TC	$299.41	$617.24	$1,070.46