Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.40 / $16.61 / $57.97	Facility	26	$11.40	$16.61	$57.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.94 / $55.84 / $147.66	Professional		$40.94	$55.84	$147.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $20.18 / $41.23	Professional	26	$11.40	$20.18	$41.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.02 / $40.61 / $103.89	Professional	TC	$31.02	$40.61	$103.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.10 / $61.69 / $88.49	Professional		$40.10	$61.69	$88.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.40 / $16.45 / $22.72	Professional	26	$10.40	$16.45	$22.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.77 / $65.37 / $67.52	Professional	TC	$45.77	$65.37	$67.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $65.40 / $126.59	Professional		$46.35	$65.40	$126.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $19.63 / $35.43	Professional	26	$12.22	$19.63	$35.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.53 / $45.82 / $95.67	Professional	TC	$31.53	$45.82	$95.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.37 / $43.63 / $79.88	Professional		$13.37	$43.63	$79.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.97 / $75.00 / $134.35	Professional		$44.97	$75.00	$134.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $23.02 / $39.58	Professional	26	$13.87	$23.02	$39.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $55.53 / $97.29	Professional	TC	$32.79	$55.53	$97.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.60 / $91.82 / $192.51	Professional		$57.60	$91.82	$192.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $22.65 / $55.33	Professional	26	$13.92	$22.65	$55.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.68 / $69.64 / $146.00	Professional	TC	$43.68	$69.64	$146.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $54.11 / $92.32	Professional		$17.14	$54.11	$92.32
United Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $64.39 / $112.22	Professional		$47.00	$64.39	$112.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $19.70 / $31.23	Professional	26	$13.37	$19.70	$31.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.81 / $45.41 / $81.36	Professional	TC	$32.81	$45.41	$81.36