Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $21.53 / $68.34	Facility	26	$13.15	$21.53	$68.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $54.84 / $206.73	Professional		$42.24	$54.84	$206.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $20.36 / $43.89	Professional	26	$13.09	$20.36	$43.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.75 / $37.86 / $78.17	Professional	TC	$28.75	$37.86	$78.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.10 / $60.18 / $88.41	Professional		$39.10	$60.18	$88.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $21.04 / $26.94	Professional	26	$12.58	$21.04	$26.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $59.00 / $59.00	Professional	TC	$59.00	$59.00	$59.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.94 / $65.70 / $128.40	Professional		$45.94	$65.70	$128.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.22 / $21.00 / $41.06	Professional	26	$14.22	$21.00	$41.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.31 / $44.48 / $87.35	Professional	TC	$31.31	$44.48	$87.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $17.71	Facility	26	$17.71	$17.71	$17.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.53 / $77.06 / $134.59	Professional		$46.53	$77.06	$134.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $25.12 / $41.56	Professional	26	$14.76	$25.12	$41.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.60 / $54.97 / $94.59	Professional	TC	$32.60	$54.97	$94.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.87 / $89.07 / $186.75	Professional		$55.87	$89.07	$186.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $26.22 / $57.80	Professional	26	$16.45	$26.22	$57.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.42 / $62.85 / $136.84	Professional	TC	$39.42	$62.85	$136.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.61 / $52.75 / $94.16	Professional		$21.61	$52.75	$94.16
United Facility/Professional Professional Modifier Low / Median / High Price $47.32 / $64.73 / $113.82	Professional		$47.32	$64.73	$113.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $20.26 / $34.99	Professional	26	$14.23	$20.26	$34.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $43.62 / $77.43	Professional	TC	$32.40	$43.62	$77.43