Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $380.19 / $776.25	Professional		$302.00	$380.19	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $97.72	Professional	26	$32.36	$42.66	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $338.84 / $602.56	Professional	TC	$263.03	$338.84	$602.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $21.88 / $21.88	Professional	26	$21.88	$21.88	$21.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $371.54 / $870.96	Professional		$218.78	$371.54	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $45.71 / $91.20	Professional	26	$20.89	$45.71	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $316.23 / $794.33	Professional	TC	$194.98	$316.23	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $398.11 / $1,174.90	Professional		$194.98	$398.11	$1,174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.88 / $125.89	Professional	26	$23.44	$33.88	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $257.04 / $954.99	Professional	TC	$169.82	$257.04	$954.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $602.56 / $3,548.13	Professional		$363.08	$602.56	$3,548.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $69.18 / $380.19	Professional	26	$41.69	$69.18	$380.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $537.03 / $3,162.28	Professional	TC	$316.23	$537.03	$3,162.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $363.08 / $776.25	Professional		$47.86	$363.08	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $457.09 / $933.25	Professional		$257.04	$457.09	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $51.29 / $109.65	Professional	26	$30.20	$51.29	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $398.11 / $851.14	Professional	TC	$223.87	$398.11	$851.14