Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.69 / $77.38 / $164.36	Facility	26	$42.69	$77.38	$164.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $263.45 / $436.57	Professional		$206.63	$263.45	$436.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $49.81 / $111.63	Professional	26	$42.69	$49.81	$111.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $216.36 / $366.55	Professional	TC	$162.49	$216.36	$366.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $69.29 / $83.03	Professional	26	$55.68	$69.29	$83.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.27 / $345.22 / $694.30	Professional		$213.27	$345.22	$694.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.86 / $59.76 / $119.87	Professional	26	$39.86	$59.76	$119.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.18 / $278.22 / $578.97	Professional	TC	$173.18	$278.22	$578.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.50 / $374.80 / $672.80	Professional		$255.50	$374.80	$672.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $64.22 / $107.11	Professional	26	$46.40	$64.22	$107.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.11 / $311.08 / $571.77	Professional	TC	$208.11	$311.08	$571.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $272.87 / $372.09 / $777.45	Professional		$272.87	$372.09	$777.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.82 / $65.20 / $137.27	Professional	26	$47.82	$65.20	$137.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $225.05 / $306.89 / $654.34	Professional	TC	$225.05	$306.89	$654.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $260.30 / $446.51	Professional		$53.06	$260.30	$446.51
United Facility/Professional Professional Modifier Low / Median / High Price $269.55 / $382.88 / $601.64	Professional		$269.55	$382.88	$601.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.35 / $65.51 / $108.19	Professional	26	$47.35	$65.51	$108.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.26 / $320.19 / $569.53	Professional	TC	$224.26	$320.19	$569.53