Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $131.84 / $381.88	Facility	26	$55.00	$131.84	$381.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $351.44 / $1,175.15	Professional		$275.00	$351.44	$1,175.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $91.27 / $234.70	Professional	26	$55.00	$91.27	$234.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $264.00 / $628.03	Professional	TC	$192.00	$264.00	$628.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.46 / $175.46 / $184.13	Professional		$175.46	$175.46	$184.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.62 / $121.19 / $158.84	Professional	26	$63.62	$121.19	$158.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $252.78 / $400.00 / $901.51	Professional		$252.78	$400.00	$901.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.47 / $106.44 / $229.38	Professional	26	$75.47	$106.44	$229.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $188.37 / $297.29 / $715.97	Professional	TC	$188.37	$297.29	$715.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.06 / $98.06 / $98.06	Facility	26	$98.06	$98.06	$98.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.47 / $579.54 / $1,117.08	Professional		$311.47	$579.54	$1,117.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.84 / $137.40 / $246.02	Professional	26	$82.84	$137.40	$246.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.41 / $447.10 / $856.01	Professional	TC	$221.41	$447.10	$856.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.07 / $588.24 / $1,466.39	Professional		$331.07	$588.24	$1,466.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.48 / $145.83 / $317.31	Professional	26	$91.48	$145.83	$317.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $239.59 / $435.62 / $1,466.39	Professional	TC	$239.59	$435.62	$1,466.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $113.11 / $287.42 / $544.13	Professional		$113.11	$287.42	$544.13
United Facility/Professional Professional Modifier Low / Median / High Price $311.47 / $498.35 / $923.53	Professional		$311.47	$498.35	$923.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.48 / $116.87 / $205.28	Professional	26	$83.48	$116.87	$205.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.80 / $387.95 / $786.29	Professional	TC	$218.80	$387.95	$786.29