Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $281.84 / $537.03	Facility	26	$208.93	$281.84	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $549.54	Professional		$190.55	$275.42	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $114.82 / $269.15	Professional	26	$54.95	$114.82	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $144.54 / $257.04	Professional	TC	$100.00	$144.54	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $123.03	Professional	26	$87.10	$87.10	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $549.54 / $870.96	Professional		$269.15	$549.54	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $147.91 / $229.09	Professional	26	$107.15	$147.91	$229.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $407.38 / $645.65	Professional	TC	$158.49	$407.38	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $616.60 / $1,096.48	Professional		$363.08	$616.60	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $158.49 / $302.00	Professional	26	$93.33	$158.49	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $457.09 / $812.83	Professional	TC	$263.03	$457.09	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $537.03 / $1,778.28	Professional		$416.87	$537.03	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $147.91 / $436.52	Professional	26	$112.20	$147.91	$436.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $398.11 / $1,412.54	Professional	TC	$302.00	$398.11	$1,412.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $776.25	Professional		$512.86	$512.86	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $1,023.29	Professional		$407.38	$537.03	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $134.90 / $263.03	Professional	26	$104.71	$134.90	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $389.05 / $741.31	Professional	TC	$295.12	$389.05	$741.31