Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $162.18 / $302.00	Facility	26	$57.54	$162.18	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $331.13 / $776.25	Professional		$229.09	$331.13	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $181.97	Professional	26	$51.29	$75.86	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $257.04 / $575.44	Professional	TC	$186.21	$257.04	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $79.43 / $117.49	Professional	26	$58.88	$79.43	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $616.60	Professional		$263.03	$398.11	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $89.13 / $131.83	Professional	26	$66.07	$89.13	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $309.03 / $501.19	Professional	TC	$181.97	$309.03	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $562.34 / $851.14	Professional		$309.03	$562.34	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $109.65 / $173.78	Professional	26	$67.61	$109.65	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $436.52 / $707.95	Professional	TC	$239.88	$436.52	$707.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $549.54 / $1,412.54	Professional		$346.74	$549.54	$1,412.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $416.87	Professional	26	$70.79	$112.20	$416.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $446.68 / $1,023.29	Professional	TC	$275.42	$446.68	$1,023.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $338.84 / $446.68	Professional		$89.13	$338.84	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $812.83	Professional		$316.23	$478.63	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $97.72 / $165.96	Professional	26	$67.61	$97.72	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $363.08 / $645.65	Professional	TC	$251.19	$363.08	$645.65