Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.54 / $516.01 / $705.68	Professional		$412.54	$516.01	$705.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.69 / $51.79 / $65.00	Professional	26	$38.69	$51.79	$65.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $361.00 / $439.00 / $627.26	Professional	TC	$361.00	$439.00	$627.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.86 / $68.86 / $68.86	Professional	26	$68.86	$68.86	$68.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.92 / $259.92 / $1,153.86	Professional		$259.92	$259.92	$1,153.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.34 / $24.34 / $113.61	Professional	26	$24.34	$24.34	$113.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.58 / $235.58 / $1,035.70	Professional	TC	$235.58	$235.58	$1,035.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.14 / $513.28 / $1,623.46	Professional		$279.14	$513.28	$1,623.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.33 / $48.55 / $148.79	Professional	26	$29.33	$48.55	$148.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.99 / $441.49 / $1,323.14	Professional	TC	$249.99	$441.49	$1,323.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $487.04 / $815.30 / $4,933.18	Professional		$487.04	$815.30	$4,933.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.23 / $82.41 / $454.31	Professional	26	$49.23	$82.41	$454.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $437.81 / $732.89 / $4,478.80	Professional	TC	$437.81	$732.89	$4,478.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.44 / $511.69 / $917.46	Professional		$57.44	$511.69	$917.46
United Facility/Professional Professional Modifier Low / Median / High Price $336.31 / $588.25 / $1,244.09	Professional		$336.31	$588.25	$1,244.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $60.23 / $144.18	Professional	26	$35.35	$60.23	$144.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.50 / $528.02 / $1,094.32	Professional	TC	$300.50	$528.02	$1,094.32