Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.38 / $271.87 / $613.71	Professional		$154.38	$271.87	$613.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.42 / $119.66 / $200.15	Professional	26	$86.42	$119.66	$200.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.41 / $94.71 / $183.57	Professional	TC	$75.41	$94.71	$183.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $114.43 / $114.43	Professional		$109.13	$114.43	$114.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.06 / $221.17 / $538.99	Professional		$109.06	$221.17	$538.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $122.56 / $291.80	Professional	26	$51.84	$122.56	$291.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.27 / $87.31 / $231.56	Professional	TC	$58.27	$87.31	$231.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.08 / $223.93 / $627.04	Professional		$108.08	$223.93	$627.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.81 / $119.09 / $315.32	Professional	26	$60.81	$119.09	$315.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.99 / $74.93 / $314.27	Professional	TC	$43.99	$74.93	$314.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.97 / $344.79 / $1,900.56	Professional		$205.97	$344.79	$1,900.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.74 / $171.98 / $1,014.99	Professional	26	$102.74	$171.98	$1,014.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $103.23 / $172.81 / $885.58	Professional	TC	$103.23	$172.81	$885.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $111.98 / $199.88 / $391.52	Professional		$111.98	$199.88	$391.52
United Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $247.49 / $546.76	Professional		$144.04	$247.49	$546.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.29 / $133.82 / $274.20	Professional	26	$80.29	$133.82	$274.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.75 / $106.47 / $284.73	Professional	TC	$63.75	$106.47	$284.73