Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $44.25 / $68.34	Facility	26	$13.15	$44.25	$68.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.71 / $105.88 / $392.61	Facility	TC	$25.71	$105.88	$392.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.09 / $40.96 / $101.49	Professional		$34.09	$40.96	$101.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $14.96 / $44.25	Professional	26	$12.50	$14.96	$44.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $25.78 / $66.94	Professional	TC	$21.84	$25.78	$66.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $75.12 / $82.25	Professional		$39.53	$75.12	$82.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $12.92 / $23.41	Professional	26	$11.01	$12.92	$23.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.32 / $51.11 / $106.72	Professional		$39.32	$51.11	$106.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $19.86 / $33.72	Professional	26	$13.82	$19.86	$33.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.80 / $35.03 / $73.14	Professional	TC	$23.80	$35.03	$73.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $63.84 / $118.64	Professional		$41.16	$63.84	$118.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $24.57 / $42.42	Professional	26	$15.56	$24.57	$42.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $40.89 / $77.19	Professional	TC	$24.83	$40.89	$77.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $77.68 / $381.26	Professional		$48.73	$77.68	$381.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.69 / $20.53 / $52.43	Professional	26	$15.69	$20.53	$52.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $43.24 / $110.41	Professional	TC	$33.03	$43.24	$110.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.16 / $42.69 / $75.61	Professional		$17.16	$42.69	$75.61
United Facility/Professional Professional Modifier Low / Median / High Price $40.92 / $54.72 / $96.76	Professional		$40.92	$54.72	$96.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $20.78 / $35.36	Professional	26	$15.31	$20.78	$35.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.47 / $33.84 / $63.03	Professional	TC	$25.47	$33.84	$63.03