Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $23.44 / $58.88	Facility	26	$11.48	$23.44	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $75.86 / $199.53	Professional		$42.66	$75.86	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $22.39 / $51.29	Professional	26	$10.96	$22.39	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $93.33	Professional	TC	$30.90	$47.86	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $89.13	Professional		$34.67	$44.67	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $21.88	Professional	26	$10.00	$13.80	$21.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $37.15 / $67.61	Professional	TC	$26.92	$37.15	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $107.15	Professional		$47.86	$61.66	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $31.62	Professional	26	$14.13	$19.95	$31.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $42.66 / $79.43	Professional	TC	$32.36	$42.66	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $43.65 / $66.07	Professional		$13.49	$43.65	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $128.82	Professional		$42.66	$70.79	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $21.38 / $35.48	Professional	26	$13.18	$21.38	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $50.12 / $97.72	Professional	TC	$31.62	$50.12	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $162.18	Professional		$56.23	$72.44	$162.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.78 / $47.86	Professional	26	$13.18	$17.78	$47.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $56.23 / $134.90	Professional	TC	$42.66	$56.23	$134.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $51.29 / $91.20	Professional		$14.13	$51.29	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $112.20	Professional		$45.71	$60.26	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.98 / $30.90	Professional	26	$12.59	$16.98	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $42.66 / $79.43	Professional	TC	$31.62	$42.66	$79.43