Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $186.21 / $398.11	Facility	26	$85.11	$186.21	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $977.24	Professional		$275.42	$426.58	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $125.89 / $323.59	Professional	26	$83.18	$125.89	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $309.03 / $562.34	Professional	TC	$186.21	$309.03	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $380.19	Professional	26	$75.86	$107.15	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $954.99	Professional		$316.23	$524.81	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $114.82 / $181.97	Professional	26	$75.86	$114.82	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $389.05 / $794.33	Professional	TC	$218.78	$389.05	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $616.60 / $1,148.15	Professional		$302.00	$616.60	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $131.83 / $223.87	Professional	26	$77.62	$131.83	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $446.68 / $933.25	Professional	TC	$218.78	$446.68	$933.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $1,621.81	Professional		$275.42	$354.81	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $302.00	Professional	26	$83.18	$112.20	$302.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $1,621.81	Professional	TC	$190.55	$245.47	$1,621.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $251.19 / $457.09	Professional		$87.10	$251.19	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $524.81 / $933.25	Professional		$281.84	$524.81	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $194.98	Professional	26	$79.43	$102.33	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $363.08 / $707.95	Professional	TC	$199.53	$363.08	$707.95