Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $245.47	Professional		$93.33	$120.23	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $22.91	Professional	26	$12.88	$15.14	$22.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $102.33 / $134.90	Professional	TC	$77.62	$102.33	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $239.88	Professional		$100.00	$117.49	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $218.78	Professional		$81.28	$123.03	$218.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.05 / $26.92	Professional	26	$13.49	$19.05	$26.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $186.21 / $323.59	Professional	50	$123.03	$186.21	$323.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $107.15 / $186.21	Professional	TC	$64.57	$107.15	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $295.12	Professional		$81.28	$123.03	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.20 / $37.15	Professional	26	$11.75	$18.20	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $263.03	Professional	TC	$69.18	$104.71	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $218.78	Professional		$109.65	$138.04	$218.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.22 / $51.29	Professional	26	$12.02	$16.22	$51.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $123.03 / $194.98	Professional	TC	$97.72	$123.03	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $125.89 / $269.15	Professional		$15.49	$125.89	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $181.97	Professional		$81.28	$104.71	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.14 / $25.12	Professional	26	$12.30	$15.14	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $89.13 / $158.49	Professional	TC	$67.61	$89.13	$158.49