Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $204.17 / $501.19	Facility	26	$85.11	$204.17	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $588.84 / $1,949.84	Professional		$398.11	$588.84	$1,949.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $154.88 / $338.84	Professional	26	$85.11	$154.88	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $891.25	Professional	TC	$281.84	$416.87	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $407.38 / $562.34	Professional		$309.03	$407.38	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $162.18 / $199.53	Professional	26	$87.10	$162.18	$199.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $323.59 / $323.59	Professional	TC	$323.59	$323.59	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $707.95 / $1,548.82	Professional		$467.74	$707.95	$1,548.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $223.87	Professional	26	$81.28	$138.04	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $602.56 / $1,380.38	Professional	TC	$407.38	$602.56	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $977.24 / $1,819.70	Professional		$501.19	$977.24	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $162.18 / $281.84	Professional	26	$97.72	$162.18	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $776.25 / $1,445.44	Professional	TC	$389.05	$776.25	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $616.60 / $2,754.23	Professional		$478.63	$616.60	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $141.25 / $380.19	Professional	26	$104.71	$141.25	$380.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $478.63 / $2,754.23	Professional	TC	$371.54	$478.63	$2,754.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $691.83 / $912.01	Professional		$158.49	$691.83	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $870.96 / $1,513.56	Professional		$501.19	$870.96	$1,513.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $128.82 / $251.19	Professional	26	$100.00	$128.82	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $691.83 / $1,258.93	Professional	TC	$398.11	$691.83	$1,258.93