Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.88 / $50.55 / $55.00	Facility	26	$18.88	$50.55	$55.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $275.00 / $279.83	Professional		$90.89	$275.00	$279.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.83 / $34.20 / $55.00	Professional	26	$11.83	$34.20	$55.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.11 / $220.00 / $240.00	Professional	TC	$79.11	$220.00	$240.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $15.98 / $15.98	Professional	26	$15.98	$15.98	$15.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.76 / $160.07 / $331.54	Professional		$95.76	$160.07	$331.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $15.89 / $33.24	Professional	26	$11.26	$15.89	$33.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.50 / $125.38 / $284.19	Professional	TC	$84.50	$125.38	$284.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.34 / $206.09 / $372.17	Professional		$115.34	$206.09	$372.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $18.96 / $35.54	Professional	26	$11.28	$18.96	$35.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.83 / $178.75 / $315.60	Professional	TC	$102.83	$178.75	$315.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.55 / $169.85 / $445.85	Professional		$106.55	$169.85	$445.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.49 / $19.89 / $43.08	Professional	26	$12.49	$19.89	$43.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $149.93 / $417.90	Professional	TC	$94.05	$149.93	$417.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.60 / $305.10 / $370.10	Professional		$251.60	$305.10	$370.10
United Facility/Professional Professional Modifier Low / Median / High Price $107.19 / $163.63 / $283.72	Professional		$107.19	$163.63	$283.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.84 / $15.73 / $27.99	Professional	26	$10.84	$15.73	$27.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.09 / $144.86 / $251.54	Professional	TC	$97.09	$144.86	$251.54