Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.87 / $167.98 / $647.83	Facility	26	$128.87	$167.98	$647.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.37 / $269.86 / $645.21	Professional		$215.37	$269.86	$645.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.52 / $151.16 / $516.19	Professional	26	$119.52	$151.16	$516.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.33 / $126.03 / $298.10	Professional	TC	$97.33	$126.03	$298.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $122.36 / $215.93 / $267.26	Professional	26	$122.36	$215.93	$267.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.94 / $343.70 / $672.06	Professional		$256.94	$343.70	$672.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $139.31 / $181.13 / $353.87	Professional	26	$139.31	$181.13	$353.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.44 / $159.21 / $318.19	Professional	TC	$121.44	$159.21	$318.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.98 / $482.32 / $776.26	Professional		$294.98	$482.32	$776.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $160.37 / $256.61 / $408.45	Professional	26	$160.37	$256.61	$408.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.60 / $223.60 / $376.74	Professional	TC	$134.60	$223.60	$376.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $311.86 / $497.16 / $2,402.21	Professional		$311.86	$497.16	$2,402.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $164.80 / $262.72 / $1,264.09	Professional	26	$164.80	$262.72	$1,264.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $147.05 / $234.42 / $1,138.10	Professional	TC	$147.05	$234.42	$1,138.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $249.85 / $524.49	Professional		$192.50	$249.85	$524.49
United Facility/Professional Professional Modifier Low / Median / High Price $271.52 / $359.31 / $758.04	Professional		$271.52	$359.31	$758.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $141.62 / $190.68 / $399.14	Professional	26	$141.62	$190.68	$399.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.78 / $170.83 / $364.65	Professional	TC	$131.78	$170.83	$364.65