Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $28.18 / $70.79	Facility	26	$13.18	$28.18	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $213.80	Professional		$39.81	$56.23	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.89 / $48.98	Professional	26	$12.88	$20.89	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.02 / $72.44	Professional	TC	$25.70	$38.02	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $61.66 / $93.33	Professional		$33.88	$61.66	$93.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $20.89 / $28.84	Professional	26	$12.59	$20.89	$28.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $36.31	Professional	TC	$34.67	$34.67	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $107.15	Professional		$46.77	$63.10	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $35.48	Professional	26	$15.14	$20.42	$35.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $75.86	Professional	TC	$32.36	$41.69	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $123.03	Professional		$41.69	$72.44	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $22.91 / $39.81	Professional	26	$14.13	$22.91	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $48.98 / $87.10	Professional	TC	$30.90	$48.98	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $173.78	Professional		$52.48	$67.61	$173.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $54.95	Professional	26	$15.14	$20.42	$54.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $47.86 / $138.04	Professional	TC	$37.15	$47.86	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $38.02 / $85.11	Professional		$15.49	$38.02	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $109.65	Professional		$47.86	$60.26	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $33.88	Professional	26	$14.13	$18.62	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $40.74 / $77.62	Professional	TC	$31.62	$40.74	$77.62