Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $22.39 / $57.54	Facility	26	$10.96	$22.39	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $44.67 / $134.90	Professional		$25.12	$44.67	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.38 / $43.65	Professional	26	$10.96	$17.38	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $66.07	Professional	TC	$21.88	$31.62	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.90 / $74.13	Professional		$27.54	$38.90	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.79 / $21.88	Professional	26	$9.55	$14.79	$21.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $45.71	Professional	TC	$21.38	$28.84	$45.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $85.11	Professional		$37.15	$47.86	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $17.78 / $28.84	Professional	26	$12.59	$17.78	$28.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $31.62 / $57.54	Professional	TC	$23.99	$31.62	$57.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $30.90 / $51.29	Professional		$13.18	$30.90	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $100.00	Professional		$33.88	$54.95	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $19.05 / $33.11	Professional	26	$11.75	$19.05	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $37.15 / $69.18	Professional	TC	$23.44	$37.15	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $54.95 / $131.83	Professional		$42.66	$54.95	$131.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $45.71	Professional	26	$12.88	$17.38	$45.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.90 / $107.15	Professional	TC	$29.51	$38.90	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $30.20 / $67.61	Professional		$13.18	$30.20	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $87.10	Professional		$37.15	$46.77	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.49 / $28.18	Professional	26	$12.30	$15.49	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $58.88	Professional	TC	$23.99	$30.90	$58.88