Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.45 / $67.94 / $337.30	Facility	26	$65.45	$67.94	$337.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.25 / $223.98 / $660.14	Professional		$183.25	$223.98	$660.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.15 / $74.73 / $206.06	Professional	26	$61.15	$74.73	$206.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $149.24 / $368.50	Professional	TC	$122.11	$149.24	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.88 / $285.22 / $285.22	Professional		$191.88	$285.22	$285.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $106.31 / $106.31 / $148.94	Professional	26	$106.31	$106.31	$148.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.53 / $311.47 / $657.84	Professional		$216.53	$311.47	$657.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.15 / $90.05 / $205.71	Professional	26	$72.15	$90.05	$205.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.37 / $190.52 / $416.91	Professional	TC	$144.37	$190.52	$416.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.75 / $391.50 / $678.33	Professional		$238.75	$391.50	$678.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.41 / $123.46 / $226.04	Professional	26	$75.41	$123.46	$226.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.68 / $267.41 / $452.29	Professional	TC	$155.68	$267.41	$452.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $236.50 / $377.02 / $2,053.23	Professional		$236.50	$377.02	$2,053.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $80.31 / $105.13 / $310.70	Professional	26	$80.31	$105.13	$310.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $156.18 / $204.45 / $604.20	Professional	TC	$156.18	$204.45	$604.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.14 / $216.96 / $396.48	Professional		$105.14	$216.96	$396.48
United Facility/Professional Professional Modifier Low / Median / High Price $250.26 / $545.70 / $1,212.95	Professional		$250.26	$545.70	$1,212.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.76 / $100.43 / $179.58	Professional	26	$67.76	$100.43	$179.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.11 / $370.25 / $1,101.43	Professional	TC	$161.11	$370.25	$1,101.43