Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.09 / $17.23 / $56.49	Facility	26	$11.09	$17.23	$56.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.31 / $42.35 / $112.30	Professional		$28.31	$42.35	$112.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $17.05 / $36.51	Professional	26	$11.05	$17.05	$36.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.90 / $28.73 / $64.31	Professional	TC	$22.90	$28.73	$64.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $69.84 / $75.66	Professional		$33.14	$69.84	$75.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $16.64 / $22.87	Professional	26	$9.97	$16.64	$22.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.80 / $46.80 / $46.80	Professional	TC	$46.80	$46.80	$46.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.20 / $52.01 / $102.54	Professional		$36.20	$52.01	$102.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $17.64 / $33.90	Professional	26	$11.95	$17.64	$33.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.24 / $33.59 / $69.25	Professional	TC	$23.24	$33.59	$69.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.06 / $31.23 / $57.25	Professional		$13.06	$31.23	$57.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.96 / $59.89 / $108.27	Professional		$35.96	$59.89	$108.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.38 / $20.89 / $34.56	Professional	26	$12.38	$20.89	$34.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.58 / $39.72 / $71.31	Professional	TC	$23.58	$39.72	$71.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $71.45 / $149.83	Professional		$44.83	$71.45	$149.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $21.60 / $47.92	Professional	26	$13.55	$21.60	$47.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.26 / $49.84 / $107.30	Professional	TC	$31.26	$49.84	$107.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.79 / $41.97 / $75.39	Professional		$17.79	$41.97	$75.39
United Facility/Professional Professional Modifier Low / Median / High Price $37.01 / $51.81 / $90.90	Professional		$37.01	$51.81	$90.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $16.78 / $30.07	Professional	26	$12.26	$16.78	$30.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $32.13 / $60.33	Professional	TC	$23.87	$32.13	$60.33