Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $178.49 / $365.53	Facility	26	$55.00	$178.49	$365.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.37 / $286.14 / $735.09	Professional		$248.37	$286.14	$735.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.00 / $236.27	Professional	26	$55.00	$83.00	$236.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.56 / $220.00 / $450.29	Professional	TC	$161.56	$220.00	$450.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.48 / $134.13 / $151.19	Professional	26	$73.48	$134.13	$151.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.58 / $319.47 / $637.24	Professional		$224.58	$319.47	$637.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.47 / $102.15 / $208.58	Professional	26	$77.47	$102.15	$208.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.33 / $221.56 / $414.21	Professional	TC	$146.33	$221.56	$414.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.58 / $412.25 / $708.36	Professional		$255.58	$412.25	$708.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.83 / $133.81 / $245.13	Professional	26	$81.83	$133.81	$245.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.62 / $267.45 / $489.96	Professional	TC	$168.62	$267.45	$489.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $246.84 / $393.51 / $2,282.89	Professional		$246.84	$393.51	$2,282.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.08 / $138.81 / $991.38	Professional	26	$87.08	$138.81	$991.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.78 / $254.71 / $908.58	Professional	TC	$159.78	$254.71	$908.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.84 / $220.99 / $387.60	Professional		$109.84	$220.99	$387.60
United Facility/Professional Professional Modifier Low / Median / High Price $233.01 / $359.15 / $575.52	Professional		$233.01	$359.15	$575.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $106.72 / $194.61	Professional	26	$79.84	$106.72	$194.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.16 / $248.95 / $418.18	Professional	TC	$159.16	$248.95	$418.18