Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.71 / $64.06 / $136.96	Facility	26	$55.71	$64.06	$136.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.84 / $399.95 / $591.86	Professional		$354.84	$399.95	$591.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.94 / $61.79 / $102.62	Professional	26	$53.94	$61.79	$102.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $177.42 / $199.54 / $294.22	Professional	52	$177.42	$199.54	$294.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.45 / $343.40 / $536.34	Professional	TC	$299.45	$343.40	$536.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.77 / $512.57 / $993.82	Professional		$301.77	$512.57	$993.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.01 / $76.23 / $161.72	Professional	26	$47.01	$76.23	$161.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $258.94 / $424.84 / $852.68	Professional	TC	$258.94	$424.84	$852.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.05 / $596.15 / $1,063.67	Professional		$431.05	$596.15	$1,063.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.57 / $91.51 / $174.49	Professional	26	$63.57	$91.51	$174.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $364.03 / $499.70 / $936.93	Professional	TC	$364.03	$499.70	$936.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $441.47 / $521.74 / $1,370.67	Professional		$441.47	$521.74	$1,370.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.70 / $72.92 / $276.60	Professional	26	$61.70	$72.92	$276.60
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $265.02 / $265.02 / $479.73	Professional	52	$265.02	$265.02	$479.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $379.79 / $448.84 / $1,179.14	Professional	TC	$379.79	$448.84	$1,179.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.86 / $547.32 / $716.25	Professional		$84.86	$547.32	$716.25
United Facility/Professional Professional Modifier Low / Median / High Price $389.69 / $660.90 / $1,062.30	Professional		$389.69	$660.90	$1,062.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $97.76 / $150.87	Professional	26	$58.71	$97.76	$150.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $333.26 / $541.84 / $911.43	Professional	TC	$333.26	$541.84	$911.43