Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $157.38 / $323.95	Facility	26	$55.00	$157.38	$323.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $352.79 / $1,714.40	Professional		$275.00	$352.79	$1,714.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.00 / $208.50	Professional	26	$55.00	$83.00	$208.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.00 / $282.23 / $729.88	Professional	TC	$220.00	$282.23	$729.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $119.23 / $130.84	Professional	26	$61.14	$119.23	$130.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $365.06 / $479.79 / $927.85	Professional		$365.06	$479.79	$927.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $86.81 / $168.92	Professional	26	$66.81	$86.81	$168.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $291.19 / $392.98 / $758.94	Professional	TC	$291.19	$392.98	$758.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.98 / $738.49 / $1,179.92	Professional		$354.98	$738.49	$1,179.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.33 / $132.78 / $198.04	Professional	26	$78.33	$132.78	$198.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $311.92 / $612.60 / $959.60	Professional	TC	$311.92	$612.60	$959.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $414.67 / $661.05 / $3,633.00	Professional		$414.67	$661.05	$3,633.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $77.43 / $123.44 / $653.94	Professional	26	$77.43	$123.44	$653.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $337.24 / $537.62 / $2,979.06	Professional	TC	$337.24	$537.62	$2,979.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.04 / $462.94 / $576.99	Professional		$105.04	$462.94	$576.99
United Facility/Professional Professional Modifier Low / Median / High Price $402.98 / $507.03 / $921.00	Professional		$402.98	$507.03	$921.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.42 / $99.81 / $173.76	Professional	26	$76.42	$99.81	$173.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $315.70 / $406.11 / $756.79	Professional	TC	$315.70	$406.11	$756.79