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 / $275.42	Facility	26	$54.95	$131.83	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $660.69	Professional		$213.80	$281.84	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $144.54	Professional	26	$51.29	$69.18	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $446.68	Professional	TC	$158.49	$218.78	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $309.03 / $467.74	Professional		$154.88	$309.03	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $85.11 / $104.71	Professional	26	$46.77	$85.11	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $363.08 / $676.08	Professional		$251.19	$363.08	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $79.43 / $120.23	Professional	26	$50.12	$79.43	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $275.42 / $549.54	Professional	TC	$204.17	$275.42	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $478.63 / $812.83	Professional		$257.04	$478.63	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $158.49	Professional	26	$52.48	$87.10	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $354.81 / $630.96	Professional	TC	$194.98	$354.81	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $331.13 / $1,023.29	Professional		$257.04	$331.13	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $77.62 / $204.17	Professional	26	$57.54	$77.62	$204.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $257.04 / $1,023.29	Professional	TC	$199.53	$257.04	$1,023.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $218.78 / $426.58	Professional		$58.88	$218.78	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $691.83	Professional		$251.19	$398.11	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $72.44 / $134.90	Professional	26	$53.70	$72.44	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $309.03 / $562.34	Professional	TC	$190.55	$309.03	$562.34