Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $25.98 / $62.42	Facility	26	$11.98	$25.98	$62.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $42.41 / $113.78	Professional		$35.36	$42.41	$113.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $13.80 / $36.34	Professional	26	$11.50	$13.80	$36.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $28.75 / $64.56	Professional	TC	$21.60	$28.75	$64.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.52 / $64.93 / $72.58	Professional		$36.52	$64.93	$72.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $19.34 / $25.38	Professional	26	$11.50	$19.34	$25.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.41 / $99.41 / $99.41	Professional	TC	$99.41	$99.41	$99.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $54.31 / $107.15	Professional		$37.94	$54.31	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $18.29 / $37.49	Professional	26	$12.12	$18.29	$37.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.86 / $34.61 / $70.88	Professional	TC	$24.86	$34.61	$70.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $15.80	Facility	26	$15.80	$15.80	$15.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $64.20 / $113.62	Professional		$38.17	$64.20	$113.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.20 / $36.93	Professional	26	$12.88	$21.20	$36.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.79 / $41.63 / $74.05	Professional	TC	$25.79	$41.63	$74.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $74.28 / $155.74	Professional		$46.60	$74.28	$155.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $23.31 / $48.89	Professional	26	$14.62	$23.31	$48.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.98 / $50.98 / $118.87	Professional	TC	$31.98	$50.98	$118.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.19 / $43.29 / $78.25	Professional		$19.19	$43.29	$78.25
United Facility/Professional Professional Modifier Low / Median / High Price $39.33 / $53.06 / $95.64	Professional		$39.33	$53.06	$95.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $16.89 / $30.32	Professional	26	$12.29	$16.89	$30.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $34.22 / $62.40	Professional	TC	$25.60	$34.22	$62.40