Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.90 / $42.25 / $138.25	Facility	26	$35.90	$42.25	$138.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.96 / $224.37 / $478.93	Professional		$183.96	$224.37	$478.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $42.25 / $89.55	Professional	26	$28.52	$42.25	$89.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.36 / $174.93 / $352.86	Professional	TC	$153.36	$174.93	$352.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.26 / $301.41 / $354.28	Professional		$146.26	$301.41	$354.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $57.32 / $67.92	Professional	26	$30.83	$57.32	$67.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.54 / $261.48 / $527.01	Professional		$171.54	$261.48	$527.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.89 / $42.16 / $81.73	Professional	26	$25.89	$42.16	$81.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.07 / $212.60 / $432.25	Professional	TC	$137.07	$212.60	$432.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $69.98	Facility	26	$43.28	$43.28	$69.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.44 / $280.33 / $525.08	Professional		$193.44	$280.33	$525.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.29 / $47.52 / $82.72	Professional	26	$26.29	$47.52	$82.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.01 / $245.31 / $443.41	Professional	TC	$158.01	$245.31	$443.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.90 / $286.23 / $604.42	Professional		$209.90	$286.23	$604.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $49.78 / $106.05	Professional	26	$37.00	$49.78	$106.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $169.75 / $231.48 / $508.48	Professional	TC	$169.75	$231.48	$508.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $200.75 / $353.02	Professional		$51.04	$200.75	$353.02
United Facility/Professional Professional Modifier Low / Median / High Price $207.79 / $294.04 / $493.07	Professional		$207.79	$294.04	$493.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.34 / $45.22 / $97.66	Professional	26	$28.34	$45.22	$97.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.15 / $252.95 / $415.77	Professional	TC	$168.15	$252.95	$415.77