Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $164.17 / $365.53	Facility	26	$85.00	$164.17	$365.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.05 / $425.00 / $1,047.93	Professional		$297.05	$425.00	$1,047.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $115.18 / $197.01	Professional	26	$85.00	$115.18	$197.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.41 / $340.00 / $783.89	Professional	TC	$202.41	$340.00	$783.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.62 / $474.24 / $942.36	Professional		$267.62	$474.24	$942.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.63 / $106.85 / $224.77	Professional	26	$76.63	$106.85	$224.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.27 / $340.70 / $755.57	Professional	TC	$190.27	$340.70	$755.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.16 / $687.00 / $1,225.93	Professional		$317.16	$687.00	$1,225.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.36 / $140.80 / $237.69	Professional	26	$79.36	$140.80	$237.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.72 / $494.13 / $976.48	Professional	TC	$239.72	$494.13	$976.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $290.52 / $528.22 / $1,634.15	Professional		$290.52	$528.22	$1,634.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $86.76 / $138.31 / $305.00	Professional	26	$86.76	$138.31	$305.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $203.76 / $370.48 / $1,591.75	Professional	TC	$203.76	$370.48	$1,591.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.03 / $277.31 / $488.60	Professional		$114.03	$277.31	$488.60
United Facility/Professional Professional Modifier Low / Median / High Price $314.91 / $567.83 / $979.70	Professional		$314.91	$567.83	$979.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.77 / $108.76 / $194.61	Professional	26	$78.77	$108.76	$194.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.36 / $400.06 / $696.81	Professional	TC	$210.36	$400.06	$696.81