Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $190.24 / $451.72	Facility	26	$85.00	$190.24	$451.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $1,204.34	Professional		$250.00	$475.00	$1,204.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $149.66 / $327.58	Professional	26	$85.00	$149.66	$327.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $374.00 / $994.50	Professional	TC	$335.00	$374.00	$994.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $307.87 / $325.24 / $491.95	Professional		$307.87	$325.24	$491.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $129.86 / $202.12	Professional	26	$81.76	$129.86	$202.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $405.50 / $610.51 / $1,432.18	Professional		$405.50	$610.51	$1,432.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.80 / $130.32 / $275.04	Professional	26	$91.80	$130.32	$275.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $308.20 / $478.15 / $1,206.50	Professional	TC	$308.20	$478.15	$1,206.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $933.85 / $1,840.84	Professional		$475.00	$933.85	$1,840.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.57 / $162.84 / $285.43	Professional	26	$98.57	$162.84	$285.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $365.26 / $752.93 / $1,470.99	Professional	TC	$365.26	$752.93	$1,470.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $441.93 / $704.51 / $2,781.45	Professional		$441.93	$704.51	$2,781.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.99 / $173.75 / $377.57	Professional	26	$108.99	$173.75	$377.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $332.94 / $605.34 / $2,781.45	Professional	TC	$332.94	$605.34	$2,781.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $420.39 / $743.24	Professional		$143.22	$420.39	$743.24
United Facility/Professional Professional Modifier Low / Median / High Price $437.84 / $777.06 / $1,450.32	Professional		$437.84	$777.06	$1,450.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $136.76 / $240.85	Professional	26	$97.98	$136.76	$240.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $344.89 / $609.21 / $1,190.59	Professional	TC	$344.89	$609.21	$1,190.59