Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.57 / $340.02 / $646.35	Facility	26	$128.57	$340.02	$646.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $371.84 / $1,001.52	Professional		$317.47	$371.84	$1,001.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.80 / $132.52 / $390.42	Professional	26	$117.80	$132.52	$390.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.98 / $242.04 / $583.47	Professional	TC	$202.98	$242.04	$583.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $616.61 / $616.61 / $616.61	Professional		$616.61	$616.61	$616.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $264.62 / $264.62 / $277.56	Professional	26	$264.62	$264.62	$277.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.10 / $482.79 / $1,073.49	Professional		$281.10	$482.79	$1,073.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.71 / $169.52 / $388.25	Professional	26	$141.71	$169.52	$388.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $216.79 / $326.89 / $714.92	Professional	TC	$216.79	$326.89	$714.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.18 / $618.50 / $1,199.70	Professional		$392.18	$618.50	$1,199.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $160.37 / $256.02 / $420.90	Professional	26	$160.37	$256.02	$420.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.57 / $349.89 / $778.81	Professional	TC	$223.57	$349.89	$778.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $495.09 / $789.26 / $3,551.00	Professional		$495.09	$789.26	$3,551.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $164.45 / $262.16 / $1,261.21	Professional	26	$164.45	$262.16	$1,261.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $330.64 / $527.10 / $2,059.58	Professional	TC	$330.64	$527.10	$2,059.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $219.57 / $472.74 / $832.64	Professional		$219.57	$472.74	$832.64
United Facility/Professional Professional Modifier Low / Median / High Price $361.75 / $464.91 / $1,076.51	Professional		$361.75	$464.91	$1,076.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $141.29 / $190.68 / $398.27	Professional	26	$141.29	$190.68	$398.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.75 / $287.13 / $621.21	Professional	TC	$208.75	$287.13	$621.21