Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.27 / $26.91 / $63.90	Facility	26	$12.27	$26.91	$63.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.55 / $72.56 / $179.43	Professional		$50.55	$72.56	$179.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $17.39 / $40.90	Professional	26	$12.23	$17.39	$40.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.52 / $49.12 / $127.78	Professional	TC	$37.52	$49.12	$127.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $79.03 / $111.66	Professional		$40.36	$79.03	$111.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.54 / $18.32 / $25.19	Professional	26	$11.54	$18.32	$25.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.58 / $79.58 / $81.70	Professional	TC	$79.58	$79.58	$81.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.92 / $79.12 / $148.90	Professional		$55.92	$79.12	$148.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $22.71 / $40.63	Professional	26	$13.86	$22.71	$40.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.06 / $54.69 / $112.76	Professional	TC	$39.06	$54.69	$112.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.63 / $50.73 / $91.89	Professional		$14.63	$50.73	$91.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $92.28 / $158.34	Professional		$54.00	$92.28	$158.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $26.15 / $43.76	Professional	26	$16.61	$26.15	$43.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.65 / $66.53 / $117.03	Professional	TC	$41.65	$66.53	$117.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.15 / $105.46 / $221.12	Professional		$66.15	$105.46	$221.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $26.28 / $63.97	Professional	26	$15.38	$26.28	$63.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.78 / $80.95 / $169.74	Professional	TC	$50.78	$80.95	$169.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $63.15 / $106.46	Professional		$19.00	$63.15	$106.46
United Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $78.22 / $131.97	Professional		$56.16	$78.22	$131.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $21.72 / $34.51	Professional	26	$14.75	$21.72	$34.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.19 / $56.86 / $97.96	Professional	TC	$40.19	$56.86	$97.96