Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $171.54 / $377.43	Facility	26	$55.00	$171.54	$377.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $277.33 / $1,146.96	Professional		$254.59	$277.33	$1,146.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.23 / $256.56	Professional	26	$55.00	$83.23	$256.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.21 / $220.00 / $762.46	Professional	TC	$173.21	$220.00	$762.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.45 / $267.45 / $267.45	Professional		$267.45	$267.45	$267.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $67.91 / $67.91	Professional	26	$67.91	$67.91	$67.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.82 / $398.48 / $899.50	Professional		$251.82	$398.48	$899.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.70 / $105.20 / $226.71	Professional	26	$75.70	$105.20	$226.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $188.37 / $299.29 / $715.97	Professional	TC	$188.37	$299.29	$715.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.39 / $575.02 / $1,108.20	Professional		$310.39	$575.02	$1,108.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $139.74 / $257.26	Professional	26	$82.50	$139.74	$257.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.21 / $447.73 / $816.42	Professional	TC	$221.21	$447.73	$816.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $329.65 / $581.50 / $1,454.71	Professional		$329.65	$581.50	$1,454.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $90.41 / $144.13 / $352.13	Professional	26	$90.41	$144.13	$352.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $239.24 / $434.98 / $1,454.71	Professional	TC	$239.24	$434.98	$1,454.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.77 / $278.02 / $514.80	Professional		$87.77	$278.02	$514.80
United Facility/Professional Professional Modifier Low / Median / High Price $310.80 / $513.67 / $919.57	Professional		$310.80	$513.67	$919.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.42 / $112.80 / $201.13	Professional	26	$82.42	$112.80	$201.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.06 / $365.35 / $667.37	Professional	TC	$216.06	$365.35	$667.37