Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.98 / $117.72 / $247.99	Professional		$90.98	$117.72	$247.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $40.99 / $110.46	Professional	26	$27.58	$40.99	$110.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.36 / $79.59 / $173.95	Professional	TC	$53.36	$79.59	$173.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $68.31 / $73.61	Professional	26	$19.57	$68.31	$73.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $116.29 / $291.38	Professional		$88.50	$116.29	$291.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $41.57 / $103.82	Professional	26	$24.51	$41.57	$103.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.99 / $81.04 / $198.36	Professional	TC	$63.99	$81.04	$198.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.20 / $138.12 / $447.54	Professional		$60.20	$138.12	$447.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.49 / $39.58 / $129.10	Professional	26	$20.49	$39.58	$129.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.18 / $72.77 / $313.72	Professional	TC	$38.18	$72.77	$313.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.93 / $217.51 / $1,068.56	Professional		$129.93	$217.51	$1,068.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.81 / $59.95 / $323.88	Professional	26	$35.81	$59.95	$323.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.11 / $157.55 / $744.68	Professional	TC	$94.11	$157.55	$744.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $137.15 / $246.50	Professional		$44.32	$137.15	$246.50
United Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $141.33 / $345.51	Professional		$80.20	$141.33	$345.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.97 / $43.31 / $105.31	Professional	26	$25.97	$43.31	$105.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.24 / $90.41 / $252.25	Professional	TC	$54.24	$90.41	$252.25