Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $186.21 / $398.11	Facility	26	$54.95	$186.21	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $724.44	Professional		$239.88	$316.23	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $89.13 / $213.80	Professional	26	$54.95	$89.13	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $467.74	Professional	TC	$158.49	$218.78	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $269.15	Professional		$190.55	$190.55	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $851.14	Professional		$251.19	$398.11	$851.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $112.20 / $177.83	Professional	26	$60.26	$112.20	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $691.83	Professional	TC	$204.17	$316.23	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $549.54 / $1,000.00	Professional		$295.12	$549.54	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $125.89 / $229.09	Professional	26	$77.62	$125.89	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $407.38 / $776.25	Professional	TC	$218.78	$407.38	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $398.11 / $1,445.44	Professional		$309.03	$398.11	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $354.81	Professional	26	$83.18	$112.20	$354.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $295.12 / $1,445.44	Professional	TC	$223.87	$295.12	$1,445.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $245.47 / $512.86	Professional		$87.10	$245.47	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $501.19 / $851.14	Professional		$295.12	$501.19	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $199.53	Professional	26	$79.43	$107.15	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $363.08 / $645.65	Professional	TC	$213.80	$363.08	$645.65