Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.75 / $61.17 / $303.14	Facility	26	$58.75	$61.17	$303.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.95 / $463.49 / $984.23	Professional		$361.95	$463.49	$984.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.37 / $67.78 / $199.20	Professional	26	$54.37	$67.78	$199.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.64 / $377.65 / $775.97	Professional	TC	$304.64	$377.65	$775.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.65 / $109.27 / $123.25	Professional	26	$2.65	$109.27	$123.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.42 / $557.42 / $1,015.52	Professional		$412.42	$557.42	$1,015.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.53 / $80.93 / $160.35	Professional	26	$62.53	$80.93	$160.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.41 / $476.49 / $860.72	Professional	TC	$354.41	$476.49	$860.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $485.47 / $827.20 / $1,309.99	Professional		$485.47	$827.20	$1,309.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.92 / $120.08 / $199.69	Professional	26	$72.92	$120.08	$199.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $410.99 / $696.07 / $1,110.30	Professional	TC	$410.99	$696.07	$1,110.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $452.93 / $722.04 / $4,714.00	Professional		$452.93	$722.04	$4,714.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.98 / $81.73 / $168.86	Professional	26	$70.98	$81.73	$168.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $381.94 / $416.66 / $908.55	Professional	TC	$381.94	$416.66	$908.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.19 / $473.35 / $1,441.67	Professional		$95.19	$473.35	$1,441.67
United Facility/Professional Professional Modifier Low / Median / High Price $480.67 / $630.75 / $1,111.79	Professional		$480.67	$630.75	$1,111.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.54 / $91.49 / $159.29	Professional	26	$67.54	$91.49	$159.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $397.49 / $549.54 / $923.44	Professional	TC	$397.49	$549.54	$923.44