Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $131.15 / $309.08	Facility	26	$85.00	$131.15	$309.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $333.64 / $465.02 / $1,047.93	Professional		$333.64	$465.02	$1,047.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.79 / $110.24 / $200.42	Professional	26	$84.79	$110.24	$200.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.93 / $340.00 / $708.55	Professional	TC	$263.93	$340.00	$708.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $278.79 / $278.79 / $349.59	Professional		$278.79	$278.79	$349.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $113.25 / $117.69 / $308.55	Professional	26	$113.25	$117.69	$308.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.54 / $508.26 / $994.85	Professional		$309.54	$508.26	$994.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.06 / $90.51 / $189.00	Professional	26	$66.06	$90.51	$189.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $247.61 / $411.80 / $846.00	Professional	TC	$247.61	$411.80	$846.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $690.08 / $1,147.82	Professional		$400.00	$690.08	$1,147.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.86 / $120.00 / $203.40	Professional	26	$66.86	$120.00	$203.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $318.02 / $550.98 / $1,009.86	Professional	TC	$318.02	$550.98	$1,009.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $362.11 / $658.38 / $1,609.17	Professional		$362.11	$658.38	$1,609.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $73.56 / $117.26 / $255.81	Professional	26	$73.56	$117.26	$255.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $288.55 / $524.64 / $1,415.93	Professional	TC	$288.55	$524.64	$1,415.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $405.08 / $625.92	Professional		$100.98	$405.08	$625.92
United Facility/Professional Professional Modifier Low / Median / High Price $398.71 / $564.26 / $1,111.59	Professional		$398.71	$564.26	$1,111.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $97.43 / $183.55	Professional	26	$66.20	$97.43	$183.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $304.14 / $474.55 / $844.11	Professional	TC	$304.14	$474.55	$844.11