Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.39 / $122.96 / $402.69	Facility	26	$79.39	$122.96	$402.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.46 / $213.11 / $652.19	Professional		$134.46	$213.11	$652.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.42 / $82.99 / $251.00	Professional	26	$60.42	$82.99	$251.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.24 / $113.34 / $463.97	Professional	TC	$57.24	$113.34	$463.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.43 / $298.51 / $298.51	Professional		$275.43	$298.51	$298.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $129.26 / $129.26	Professional	26	$68.41	$129.26	$129.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.28 / $281.70 / $731.57	Professional		$157.28	$281.70	$731.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.95 / $102.47 / $213.94	Professional	26	$66.95	$102.47	$213.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $139.94 / $651.27	Professional	TC	$69.18	$139.94	$651.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.91 / $378.65 / $910.69	Professional		$164.91	$378.65	$910.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.65 / $121.34 / $246.73	Professional	26	$68.65	$121.34	$246.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.20 / $214.15 / $539.83	Professional	TC	$82.20	$214.15	$539.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.04 / $316.44 / $1,426.76	Professional		$174.04	$316.44	$1,426.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $98.03 / $156.28 / $379.27	Professional	26	$98.03	$156.28	$379.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.01 / $138.19 / $1,298.13	Professional	TC	$76.01	$138.19	$1,298.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.74 / $147.41 / $277.77	Professional		$96.74	$147.41	$277.77
United Facility/Professional Professional Modifier Low / Median / High Price $168.15 / $293.51 / $596.99	Professional		$168.15	$293.51	$596.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.88 / $103.74 / $197.92	Professional	26	$65.88	$103.74	$197.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.29 / $144.86 / $463.63	Professional	TC	$76.29	$144.86	$463.63