Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $170.08 / $395.27	Facility	26	$55.00	$170.08	$395.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.93 / $302.33 / $883.40	Professional		$222.93	$302.33	$883.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $95.37 / $285.66	Professional	26	$55.00	$95.37	$285.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $230.02 / $670.26	Professional	TC	$192.00	$230.02	$670.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.78 / $121.73 / $160.38	Professional	26	$72.78	$121.73	$160.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.35 / $410.00 / $942.49	Professional		$256.35	$410.00	$942.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.05 / $109.63 / $234.36	Professional	26	$77.05	$109.63	$234.36
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $384.53 / $637.59 / $1,413.73	Professional	50	$384.53	$637.59	$1,413.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $188.76 / $317.54 / $725.51	Professional	TC	$188.76	$317.54	$725.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.05 / $623.99 / $1,080.78	Professional		$337.05	$623.99	$1,080.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.46 / $146.25 / $270.41	Professional	26	$87.46	$146.25	$270.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $260.62 / $468.32 / $856.40	Professional	TC	$260.62	$468.32	$856.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $349.57 / $557.28 / $1,365.00	Professional		$349.57	$557.28	$1,365.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $95.03 / $151.49 / $369.20	Professional	26	$95.03	$151.49	$369.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $254.54 / $405.78 / $1,365.00	Professional	TC	$254.54	$405.78	$1,365.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $323.95 / $553.37	Professional		$123.44	$323.95	$553.37
United Facility/Professional Professional Modifier Low / Median / High Price $336.65 / $526.90 / $910.99	Professional		$336.65	$526.90	$910.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.06 / $118.64 / $211.48	Professional	26	$86.06	$118.64	$211.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.98 / $399.75 / $718.31	Professional	TC	$248.98	$399.75	$718.31