Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $250.12 / $505.19	Facility	26	$55.00	$250.12	$505.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.16 / $275.00 / $610.20	Professional		$217.16	$275.00	$610.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $89.60 / $271.45	Professional	26	$55.00	$89.60	$271.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.58 / $220.00 / $279.04	Professional	TC	$110.58	$220.00	$279.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $521.96 / $985.16	Professional		$225.00	$521.96	$985.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.38 / $142.27 / $261.58	Professional	26	$103.38	$142.27	$261.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.87 / $408.30 / $745.08	Professional	TC	$112.87	$408.30	$745.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $395.04 / $700.91 / $1,219.99	Professional		$395.04	$700.91	$1,219.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.08 / $174.80 / $329.68	Professional	26	$104.08	$174.80	$329.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $282.98 / $512.94 / $918.96	Professional	TC	$282.98	$512.94	$918.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $444.43 / $708.51 / $2,530.00	Professional		$444.43	$708.51	$2,530.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.47 / $193.65 / $455.40	Professional	26	$121.47	$193.65	$455.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $322.95 / $514.86 / $2,074.60	Professional	TC	$322.95	$514.86	$2,074.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $195.77 / $528.48 / $748.33	Professional		$195.77	$528.48	$748.33
United Facility/Professional Professional Modifier Low / Median / High Price $418.15 / $582.04 / $1,032.05	Professional		$418.15	$582.04	$1,032.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.58 / $147.24 / $269.08	Professional	26	$106.58	$147.24	$269.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $306.14 / $433.94 / $770.71	Professional	TC	$306.14	$433.94	$770.71