Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.14 / $73.30 / $158.38	Facility	26	$41.14	$73.30	$158.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $151.71 / $377.85	Professional		$133.29	$151.71	$377.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.14 / $48.15 / $116.73	Professional	26	$41.14	$48.15	$116.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.77 / $105.93 / $249.70	Professional	TC	$91.77	$105.93	$249.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $243.05 / $243.05 / $243.05	Professional		$243.05	$243.05	$243.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.42 / $74.78 / $97.09	Professional	26	$60.42	$74.78	$97.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.09 / $237.77 / $440.12	Professional		$126.09	$237.77	$440.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.84 / $72.45 / $137.07	Professional	26	$40.84	$72.45	$137.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.86 / $156.26 / $307.87	Professional	TC	$85.86	$156.26	$307.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.51 / $224.82 / $423.69	Professional		$146.51	$224.82	$423.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.43 / $70.15 / $127.48	Professional	26	$49.43	$70.15	$127.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.10 / $157.03 / $282.02	Professional	TC	$99.10	$157.03	$282.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $196.37 / $490.05	Professional		$144.00	$196.37	$490.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.65 / $62.25 / $167.33	Professional	26	$45.65	$62.25	$167.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $98.36 / $134.13 / $490.05	Professional	TC	$98.36	$134.13	$490.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $155.58 / $254.00	Professional		$66.45	$155.58	$254.00
United Facility/Professional Professional Modifier Low / Median / High Price $135.83 / $201.28 / $388.13	Professional		$135.83	$201.28	$388.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $62.33 / $119.30	Professional	26	$45.95	$62.33	$119.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.77 / $136.63 / $263.49	Professional	TC	$90.77	$136.63	$263.49