Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.19 / $58.88 / $158.49	Facility	26	$53.19	$58.88	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $377.83 / $428.04 / $790.05	Professional		$377.83	$428.04	$790.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $60.54 / $146.66	Professional	26	$53.19	$60.54	$146.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $317.69 / $369.41 / $661.88	Professional	TC	$317.69	$369.41	$661.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $404.34 / $708.76 / $789.50	Professional		$404.34	$708.76	$789.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.34 / $96.41 / $101.13	Professional	26	$66.34	$96.41	$101.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.92 / $521.80 / $1,066.19	Professional		$317.92	$521.80	$1,066.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $78.75 / $160.02	Professional	26	$44.34	$78.75	$160.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $258.13 / $442.68 / $921.17	Professional	TC	$258.13	$442.68	$921.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.82 / $580.84 / $1,128.88	Professional		$402.82	$580.84	$1,128.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.93 / $98.89 / $172.40	Professional	26	$61.93	$98.89	$172.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $343.44 / $499.18 / $939.50	Professional	TC	$343.44	$499.18	$939.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.76 / $552.80 / $1,452.31	Professional		$467.76	$552.80	$1,452.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.92 / $70.81 / $376.48	Professional	26	$59.92	$70.81	$376.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $407.85 / $482.00 / $1,282.00	Professional	TC	$407.85	$482.00	$1,282.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.13 / $641.75 / $804.90	Professional		$93.13	$641.75	$804.90
United Facility/Professional Professional Modifier Low / Median / High Price $381.01 / $615.41 / $1,169.53	Professional		$381.01	$615.41	$1,169.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $93.56 / $156.41	Professional	26	$55.92	$93.56	$156.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $307.06 / $505.75 / $973.61	Professional	TC	$307.06	$505.75	$973.61