Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $170.89 / $377.43	Facility	26	$85.00	$170.89	$377.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $404.04 / $475.00 / $1,029.33	Professional		$404.04	$475.00	$1,029.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $135.74 / $245.99	Professional	26	$85.00	$135.74	$245.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $303.37 / $340.00 / $796.51	Professional	TC	$303.37	$340.00	$796.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.87 / $138.60 / $151.83	Professional	26	$62.87	$138.60	$151.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.25 / $531.35 / $1,007.60	Professional		$330.25	$531.35	$1,007.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.59 / $109.83 / $230.30	Professional	26	$78.59	$109.83	$230.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $249.39 / $396.66 / $809.26	Professional	TC	$249.39	$396.66	$809.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.95 / $96.95 / $96.95	Facility	26	$96.95	$96.95	$96.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.47 / $685.54 / $1,204.74	Professional		$389.47	$685.54	$1,204.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.40 / $147.16 / $249.00	Professional	26	$83.40	$147.16	$249.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.07 / $514.83 / $941.03	Professional	TC	$302.07	$514.83	$941.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $360.11 / $574.08 / $1,583.50	Professional		$360.11	$574.08	$1,583.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.96 / $143.41 / $313.67	Professional	26	$89.96	$143.41	$313.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $270.14 / $430.67 / $1,396.22	Professional	TC	$270.14	$430.67	$1,396.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.49 / $382.57 / $628.50	Professional		$123.49	$382.57	$628.50
United Facility/Professional Professional Modifier Low / Median / High Price $370.00 / $563.28 / $966.67	Professional		$370.00	$563.28	$966.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.66 / $115.44 / $200.94	Professional	26	$80.66	$115.44	$200.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.97 / $432.64 / $748.73	Professional	TC	$282.97	$432.64	$748.73