Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $371.54 / $691.83	Facility	26	$128.82	$371.54	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $1,000.00	Professional		$309.03	$436.52	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $151.36 / $398.11	Professional	26	$109.65	$151.36	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $269.15 / $588.84	Professional	TC	$190.55	$269.15	$588.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $257.04 / $281.84	Professional	26	$144.54	$257.04	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $407.38 / $776.25	Professional		$204.17	$407.38	$776.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $169.82 / $295.12	Professional	26	$144.54	$169.82	$295.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $234.42 / $562.34	Professional	TC	$199.53	$234.42	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $602.56 / $1,202.26	Professional		$407.38	$602.56	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $239.88 / $407.38	Professional	26	$151.36	$239.88	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $794.33	Professional	TC	$229.09	$338.84	$794.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $616.60 / $2,398.83	Professional		$512.86	$616.60	$2,398.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $199.53 / $1,000.00	Professional	26	$169.82	$199.53	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $407.38 / $1,380.38	Professional	TC	$346.74	$407.38	$1,380.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $436.52 / $741.31	Professional		$213.80	$436.52	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $1,202.26	Professional		$354.81	$478.63	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $186.21 / $389.05	Professional	26	$141.25	$186.21	$389.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $295.12 / $741.31	Professional	TC	$204.17	$295.12	$741.31