Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $161.80 / $375.95	Facility	26	$85.00	$161.80	$375.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.42 / $475.00 / $1,240.60	Professional		$331.42	$475.00	$1,240.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $128.66 / $245.85	Professional	26	$85.00	$128.66	$245.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $138.18 / $212.50 / $620.30	Professional	52	$138.18	$212.50	$620.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $210.54 / $340.00 / $783.89	Professional	TC	$210.54	$340.00	$783.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.12 / $179.11 / $376.57	Professional		$163.12	$179.11	$376.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.40 / $133.21 / $143.37	Professional	26	$71.40	$133.21	$143.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.50 / $468.07 / $954.80	Professional		$267.50	$468.07	$954.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $111.23 / $232.56	Professional	26	$79.06	$111.23	$232.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.96 / $318.60 / $763.17	Professional	TC	$186.96	$318.60	$763.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.11 / $652.62 / $1,232.56	Professional		$313.11	$652.62	$1,232.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $143.41 / $240.00	Professional	26	$81.95	$143.41	$240.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.88 / $489.98 / $972.40	Professional	TC	$224.88	$489.98	$972.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $293.01 / $532.74 / $1,666.31	Professional		$293.01	$532.74	$1,666.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.61 / $142.85 / $313.60	Professional	26	$89.61	$142.85	$313.60
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $243.94 / $243.94 / $342.80	Professional	52	$243.94	$243.94	$342.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $203.41 / $369.84 / $1,617.95	Professional	TC	$203.41	$369.84	$1,617.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.12 / $278.61 / $491.37	Professional		$116.12	$278.61	$491.37
United Facility/Professional Professional Modifier Low / Median / High Price $297.45 / $527.48 / $961.60	Professional		$297.45	$527.48	$961.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.31 / $109.92 / $201.08	Professional	26	$79.31	$109.92	$201.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.54 / $354.98 / $689.72	Professional	TC	$211.54	$354.98	$689.72