Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.23 / $279.29 / $436.84	Facility	26	$86.23	$279.29	$436.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $315.56 / $734.52	Professional		$255.00	$315.56	$734.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.98 / $97.74 / $243.36	Professional	26	$78.98	$97.74	$243.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.01 / $217.81 / $532.60	Professional	TC	$176.01	$217.81	$532.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $415.71 / $415.71 / $415.71	Professional		$415.71	$415.71	$415.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $168.17 / $176.81 / $186.51	Professional	26	$168.17	$176.81	$186.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.80 / $389.81 / $813.82	Professional		$294.80	$389.81	$813.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.40 / $117.90 / $238.25	Professional	26	$92.40	$117.90	$238.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $201.46 / $275.69 / $575.57	Professional	TC	$201.46	$275.69	$575.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.29 / $552.59 / $906.83	Professional		$331.29	$552.59	$906.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.80 / $173.44 / $283.07	Professional	26	$108.80	$173.44	$283.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.49 / $369.81 / $636.89	Professional	TC	$222.49	$369.81	$636.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $372.89 / $594.45 / $2,750.00	Professional		$372.89	$594.45	$2,750.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $110.51 / $176.17 / $846.00	Professional	26	$110.51	$176.17	$846.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $262.39 / $418.30 / $1,897.50	Professional	TC	$262.39	$418.30	$1,897.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.16 / $376.33 / $627.13	Professional		$148.16	$376.33	$627.13
United Facility/Professional Professional Modifier Low / Median / High Price $316.68 / $412.78 / $826.77	Professional		$316.68	$412.78	$826.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.49 / $129.19 / $233.98	Professional	26	$95.49	$129.19	$233.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.68 / $283.27 / $569.91	Professional	TC	$217.68	$283.27	$569.91