Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $186.21 / $398.11	Facility	26	$85.11	$186.21	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,288.25	Professional		$346.74	$478.63	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $131.83 / $281.84	Professional	26	$83.18	$131.83	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $758.58	Professional	TC	$257.04	$338.84	$758.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $147.91	Professional	26	$75.86	$95.50	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $549.54 / $954.99	Professional		$389.05	$549.54	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $112.20 / $177.83	Professional	26	$75.86	$112.20	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $426.58 / $758.58	Professional	TC	$295.12	$426.58	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $660.69 / $1,096.48	Professional		$380.19	$660.69	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $128.82 / $229.09	Professional	26	$77.62	$128.82	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $501.19 / $891.25	Professional	TC	$295.12	$501.19	$891.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $1,445.44	Professional		$338.84	$446.68	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $109.65 / $302.00	Professional	26	$83.18	$109.65	$302.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $331.13 / $1,380.38	Professional	TC	$257.04	$331.13	$1,380.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $281.84 / $616.60	Professional		$87.10	$281.84	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $549.54 / $912.01	Professional		$354.81	$549.54	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $190.55	Professional	26	$79.43	$100.00	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $426.58 / $691.83	Professional	TC	$269.15	$426.58	$691.83