Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $61.66 / $181.97	Facility	26	$52.48	$61.66	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $851.14	Professional		$371.54	$446.68	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $204.17	Professional	26	$52.48	$74.13	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $380.19 / $776.25	Professional	TC	$316.23	$380.19	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $707.95	Professional		$575.44	$575.44	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $112.20	Professional	26	$61.66	$70.79	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $588.84 / $1,047.13	Professional		$316.23	$588.84	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $147.91	Professional	26	$58.88	$85.11	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $426.58 / $812.83	Professional	TC	$208.93	$426.58	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $1,148.15	Professional		$416.87	$588.84	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $100.00 / $173.78	Professional	26	$61.66	$100.00	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $524.81 / $954.99	Professional	TC	$346.74	$524.81	$954.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $630.96 / $1,548.82	Professional		$512.86	$630.96	$1,548.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $75.86 / $380.19	Professional	26	$61.66	$75.86	$380.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $562.34 / $1,348.96	Professional	TC	$446.68	$562.34	$1,348.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $602.56 / $812.83	Professional		$89.13	$602.56	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $588.84 / $1,148.15	Professional		$380.19	$588.84	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $93.33 / $158.49	Professional	26	$56.23	$93.33	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $501.19 / $1,000.00	Professional	TC	$323.59	$501.19	$1,000.00