Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $110.76 / $257.05	Facility	26	$55.00	$110.76	$257.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.62 / $275.00 / $741.76	Professional		$186.62	$275.00	$741.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.68 / $73.89 / $189.60	Professional	26	$54.68	$73.89	$189.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.89 / $220.00 / $516.12	Professional	TC	$124.89	$220.00	$516.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $222.13 / $222.13 / $222.13	Professional		$222.13	$222.13	$222.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.03 / $73.18 / $103.54	Professional	26	$39.03	$73.18	$103.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.81 / $291.00 / $557.27	Professional		$167.81	$291.00	$557.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.15 / $76.22 / $154.41	Professional	26	$54.15	$76.22	$154.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.28 / $203.56 / $418.43	Professional	TC	$114.28	$203.56	$418.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $66.34	Facility	26	$66.34	$66.34	$66.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.75 / $407.05 / $682.58	Professional		$213.75	$407.05	$682.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $94.72 / $174.78	Professional	26	$55.93	$94.72	$174.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.69 / $284.10 / $518.76	Professional	TC	$156.69	$284.10	$518.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.26 / $335.02 / $892.89	Professional		$184.26	$335.02	$892.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.42 / $97.92 / $247.14	Professional	26	$61.42	$97.92	$247.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $122.84 / $223.34 / $892.55	Professional	TC	$122.84	$223.34	$892.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $168.27 / $309.43	Professional		$79.77	$168.27	$309.43
United Facility/Professional Professional Modifier Low / Median / High Price $187.02 / $332.16 / $579.30	Professional		$187.02	$332.16	$579.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $78.42 / $137.84	Professional	26	$56.15	$78.42	$137.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.62 / $237.28 / $405.24	Professional	TC	$130.62	$237.28	$405.24