Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $115.46 / $257.05	Facility	26	$55.00	$115.46	$257.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.10 / $275.00 / $791.70	Professional		$238.10	$275.00	$791.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $61.24 / $154.79	Professional	26	$55.00	$61.24	$154.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.73 / $220.00 / $540.80	Professional	TC	$172.73	$220.00	$540.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $188.20 / $219.69	Professional		$149.97	$188.20	$219.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $72.70 / $97.64	Professional	26	$42.70	$72.70	$97.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.22 / $349.91 / $733.86	Professional		$233.22	$349.91	$733.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.03 / $75.00 / $158.13	Professional	26	$53.03	$75.00	$158.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.38 / $271.07 / $587.21	Professional	TC	$181.38	$271.07	$587.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.69 / $501.00 / $827.22	Professional		$263.69	$501.00	$827.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.59 / $97.45 / $166.81	Professional	26	$55.59	$97.45	$166.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.34 / $363.23 / $698.25	Professional	TC	$202.34	$363.23	$698.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.77 / $492.32 / $1,082.04	Professional		$270.77	$492.32	$1,082.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.03 / $97.29 / $213.96	Professional	26	$61.03	$97.29	$213.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $209.75 / $381.36 / $1,033.71	Professional	TC	$209.75	$381.36	$1,033.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.01 / $229.09 / $417.90	Professional		$72.01	$229.09	$417.90
United Facility/Professional Professional Modifier Low / Median / High Price $263.69 / $414.68 / $712.59	Professional		$263.69	$414.68	$712.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $76.40 / $136.13	Professional	26	$56.15	$76.40	$136.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.92 / $321.89 / $585.10	Professional	TC	$195.92	$321.89	$585.10