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 / $255.56	Facility	26	$55.00	$115.46	$255.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.81 / $275.00 / $666.68	Professional		$184.81	$275.00	$666.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $58.61 / $155.79	Professional	26	$52.78	$58.61	$155.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.24 / $220.00 / $540.95	Professional	TC	$153.24	$220.00	$540.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.91 / $147.34 / $147.34	Professional		$128.91	$147.34	$147.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.53 / $53.48 / $102.39	Professional	26	$45.53	$53.48	$102.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $236.51 / $236.51 / $236.51	Professional	TC	$236.51	$236.51	$236.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.80 / $334.58 / $649.85	Professional		$197.80	$334.58	$649.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.73 / $74.83 / $156.08	Professional	26	$52.73	$74.83	$156.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.75 / $246.38 / $498.78	Professional	TC	$139.75	$246.38	$498.78
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 $249.91 / $459.26 / $750.70	Professional		$249.91	$459.26	$750.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $94.22 / $167.63	Professional	26	$55.93	$94.22	$167.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.26 / $335.22 / $623.38	Professional	TC	$194.26	$335.22	$623.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $211.18 / $383.96 / $1,087.48	Professional		$211.18	$383.96	$1,087.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.67 / $96.71 / $213.96	Professional	26	$60.67	$96.71	$213.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $150.50 / $273.64 / $927.10	Professional	TC	$150.50	$273.64	$927.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $198.18 / $353.75	Professional		$79.23	$198.18	$353.75
United Facility/Professional Professional Modifier Low / Median / High Price $214.37 / $388.33 / $679.88	Professional		$214.37	$388.33	$679.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $78.41 / $136.13	Professional	26	$55.83	$78.41	$136.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.88 / $300.13 / $533.29	Professional	TC	$159.88	$300.13	$533.29