Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.12 / $419.66 / $430.95	Facility	26	$84.12	$419.66	$430.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $673.76 / $794.95 / $2,687.20	Professional		$673.76	$794.95	$2,687.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.84 / $94.96 / $306.48	Professional	26	$78.84	$94.96	$306.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $595.88 / $710.83 / $1,329.36	Professional	TC	$595.88	$710.83	$1,329.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.01 / $1,049.03 / $1,918.56	Professional		$776.01	$1,049.03	$1,918.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.90 / $115.05 / $227.99	Professional	26	$88.90	$115.05	$227.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $698.55 / $933.97 / $1,696.48	Professional	TC	$698.55	$933.97	$1,696.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $911.53 / $1,556.73 / $2,474.86	Professional		$911.53	$1,556.73	$2,474.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.68 / $170.70 / $286.47	Professional	26	$103.68	$170.70	$286.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $805.73 / $1,364.38 / $2,188.39	Professional	TC	$805.73	$1,364.38	$2,188.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $853.61 / $1,360.81 / $8,910.00	Professional		$853.61	$1,360.81	$8,910.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.06 / $117.44 / $242.77	Professional	26	$102.06	$117.44	$242.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $751.55 / $819.88 / $1,787.79	Professional	TC	$751.55	$819.88	$1,787.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $137.12 / $927.19 / $2,837.24	Professional		$137.12	$927.19	$2,837.24
United Facility/Professional Professional Modifier Low / Median / High Price $904.88 / $1,170.14 / $2,174.76	Professional		$904.88	$1,170.14	$2,174.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.98 / $131.38 / $229.03	Professional	26	$95.98	$131.38	$229.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $808.02 / $1,027.52 / $1,862.88	Professional	TC	$808.02	$1,027.52	$1,862.88