Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $104.71 / $151.36	Facility	26	$79.43	$104.71	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $436.52 / $891.25	Professional		$338.84	$436.52	$891.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $97.72 / $239.88	Professional	26	$79.43	$97.72	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $338.84 / $691.83	Professional	TC	$263.03	$338.84	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $794.33	Professional		$389.05	$446.68	$794.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $117.49 / $165.96	Professional	26	$79.43	$117.49	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $707.95	Professional		$251.19	$426.58	$707.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $114.82 / $165.96	Professional	26	$75.86	$114.82	$165.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $309.03 / $575.44	Professional	TC	$169.82	$309.03	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $537.03 / $1,000.00	Professional		$281.84	$537.03	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $120.23 / $208.93	Professional	26	$89.13	$120.23	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $426.58 / $851.14	Professional	TC	$223.87	$426.58	$851.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $588.84 / $1,479.11	Professional		$389.05	$588.84	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $114.82 / $316.23	Professional	26	$93.33	$114.82	$316.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $478.63 / $1,174.90	Professional	TC	$371.54	$478.63	$1,174.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $478.63 / $912.01	Professional		$97.72	$478.63	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $467.74 / $977.24	Professional		$316.23	$467.74	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $208.93	Professional	26	$83.18	$117.49	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $371.54 / $794.33	Professional	TC	$234.42	$371.54	$794.33