Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $131.83 / $281.84	Facility	26	$54.95	$131.83	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $562.34	Professional		$186.21	$275.42	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $141.25	Professional	26	$51.29	$64.57	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $213.80 / $389.05	Professional	TC	$128.82	$213.80	$389.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $56.23 / $104.71	Professional	26	$44.67	$56.23	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $660.69	Professional		$223.87	$354.81	$660.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $128.82	Professional	26	$52.48	$81.28	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $269.15 / $537.03	Professional	TC	$173.78	$269.15	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $446.68 / $758.58	Professional		$234.42	$446.68	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $91.20 / $158.49	Professional	26	$54.95	$91.20	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $331.13 / $616.60	Professional	TC	$177.83	$331.13	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $1,071.52	Professional		$199.53	$257.04	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $213.80	Professional	26	$58.88	$79.43	$213.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $1,071.52	Professional	TC	$141.25	$181.97	$1,071.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $154.88 / $331.13	Professional		$60.26	$154.88	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $380.19 / $630.96	Professional		$208.93	$380.19	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $141.25	Professional	26	$56.23	$75.86	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $288.40 / $501.19	Professional	TC	$151.36	$288.40	$501.19