Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.35 / $147.94 / $325.76	Facility		$90.35	$147.94	$325.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.16 / $29.95 / $68.34	Facility	26	$13.16	$29.95	$68.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.83 / $95.12 / $218.48	Professional		$77.83	$95.12	$218.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $16.05 / $48.61	Professional	26	$13.15	$16.05	$48.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.52 / $77.31 / $168.97	Professional	TC	$65.52	$77.31	$168.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.81 / $163.81 / $163.81	Professional		$163.81	$163.81	$163.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.23 / $23.49 / $27.64	Professional	26	$3.23	$23.49	$27.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.83 / $181.73 / $291.67	Facility		$92.83	$181.73	$291.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $116.24 / $242.70	Professional		$78.48	$116.24	$242.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $21.61 / $42.86	Professional	26	$14.78	$21.61	$42.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.81 / $99.04 / $205.62	Professional	TC	$62.81	$99.04	$205.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.88 / $194.30 / $273.95	Facility		$124.88	$194.30	$273.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.38 / $139.09 / $255.23	Professional		$79.38	$139.09	$255.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $25.79 / $41.85	Professional	26	$15.47	$25.79	$41.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.75 / $114.07 / $207.98	Professional	TC	$64.75	$114.07	$207.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.98 / $172.13 / $417.68	Professional		$107.98	$172.13	$417.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $26.15 / $63.43	Professional	26	$16.39	$26.15	$63.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.58 / $145.99 / $354.26	Professional	TC	$91.58	$145.99	$354.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.03 / $96.55 / $173.07	Professional		$16.03	$96.55	$173.07
United Facility/Professional Facility Modifier Low / Median / High Price $65.86 / $528.75 / $583.67	Facility		$65.86	$528.75	$583.67
United Facility/Professional Professional Modifier Low / Median / High Price $83.90 / $118.67 / $216.52	Professional		$83.90	$118.67	$216.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.22 / $21.35 / $35.36	Professional	26	$15.22	$21.35	$35.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.11 / $94.71 / $175.51	Professional	TC	$66.11	$94.71	$175.51