Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $173.78 / $389.05	Facility	26	$85.11	$173.78	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $1,023.29	Professional		$275.42	$426.58	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $123.03 / $208.93	Professional	26	$81.28	$123.03	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $309.03 / $588.84	Professional	TC	$190.55	$309.03	$588.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $112.20	Professional	26	$77.62	$77.62	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $933.25	Professional		$323.59	$537.03	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $109.65 / $177.83	Professional	26	$74.13	$109.65	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $398.11 / $812.83	Professional	TC	$229.09	$398.11	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $630.96 / $1,122.02	Professional		$309.03	$630.96	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $125.89 / $218.78	Professional	26	$75.86	$125.89	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $467.74 / $912.01	Professional	TC	$229.09	$467.74	$912.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $1,584.89	Professional		$275.42	$354.81	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $288.40	Professional	26	$81.28	$109.65	$288.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $251.19 / $1,584.89	Professional	TC	$190.55	$251.19	$1,584.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $245.47 / $457.09	Professional		$83.18	$245.47	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $537.03 / $912.01	Professional		$288.40	$537.03	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $190.55	Professional	26	$77.62	$97.72	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $389.05 / $691.83	Professional	TC	$204.17	$389.05	$691.83