Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $602.56	Professional		$204.17	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $131.83	Professional	26	$30.20	$43.65	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $234.42 / $588.84	Professional	TC	$165.96	$234.42	$588.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $38.02 / $75.86	Professional	26	$19.05	$38.02	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $199.53 / $575.44	Professional		$141.25	$199.53	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $81.28	Professional	26	$18.62	$18.62	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $489.78	Professional	TC	$123.03	$123.03	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $213.80 / $794.33	Professional		$102.33	$213.80	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $24.55 / $107.15	Professional	26	$20.89	$24.55	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $151.36 / $616.60	Professional	TC	$77.62	$151.36	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $407.38 / $2,754.23	Professional		$245.47	$407.38	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $60.26 / $346.74	Professional	26	$35.48	$60.26	$346.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $346.74 / $2,398.83	Professional	TC	$208.93	$346.74	$2,398.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $245.47 / $501.19	Professional		$41.69	$245.47	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $309.03 / $660.69	Professional		$186.21	$309.03	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $45.71 / $95.50	Professional	26	$27.54	$45.71	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $245.47 / $575.44	Professional	TC	$154.88	$245.47	$575.44