Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.80 / $97.89 / $207.13	Facility	26	$53.80	$97.89	$207.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.91 / $165.17 / $296.56	Professional		$152.91	$165.17	$296.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.07 / $130.91	Professional	26	$53.70	$61.07	$130.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.13 / $104.91 / $212.51	Professional	TC	$99.13	$104.91	$212.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.72 / $351.95 / $709.69	Professional		$154.72	$351.95	$709.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.25 / $72.06 / $145.01	Professional	26	$50.25	$72.06	$145.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.45 / $273.04 / $583.33	Professional	TC	$102.45	$273.04	$583.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $66.70	Facility	26	$66.70	$66.70	$66.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.10 / $415.80 / $718.20	Professional		$267.10	$415.80	$718.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $80.06 / $136.28	Professional	26	$57.65	$80.06	$136.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.97 / $334.66 / $590.33	Professional	TC	$213.97	$334.66	$590.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $311.64 / $368.32 / $823.26	Professional		$311.64	$368.32	$823.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.73 / $84.18 / $163.06	Professional	26	$61.73	$84.18	$163.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $249.93 / $318.08 / $660.20	Professional	TC	$249.93	$318.08	$660.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.23 / $292.50 / $509.22	Professional		$68.23	$292.50	$509.22
United Facility/Professional Professional Modifier Low / Median / High Price $290.26 / $397.63 / $676.47	Professional		$290.26	$397.63	$676.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.57 / $80.39 / $127.14	Professional	26	$59.57	$80.39	$127.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.90 / $309.47 / $518.53	Professional	TC	$227.90	$309.47	$518.53