Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $14.43 / $49.03	Facility	26	$9.34	$14.43	$49.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $43.73 / $107.36	Professional		$32.11	$43.73	$107.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $13.96 / $30.56	Professional	26	$9.30	$13.96	$30.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $28.46 / $73.83	Professional	TC	$22.08	$28.46	$73.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $34.06 / $66.33	Professional		$25.67	$34.06	$66.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $13.62 / $19.82	Professional	26	$8.00	$13.62	$19.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $47.78 / $49.17	Professional	TC	$23.46	$47.78	$49.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $48.96 / $96.30	Professional		$34.40	$48.96	$96.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $14.56 / $29.46	Professional	26	$10.11	$14.56	$29.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $34.11 / $67.70	Professional	TC	$24.26	$34.11	$67.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.98 / $30.51 / $55.95	Professional		$10.98	$30.51	$55.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $55.81 / $101.89	Professional		$32.15	$55.81	$101.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.71 / $28.85	Professional	26	$10.23	$16.71	$28.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $40.97 / $71.05	Professional	TC	$25.10	$40.97	$71.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $66.92 / $140.32	Professional		$41.98	$66.92	$140.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $18.20 / $38.17	Professional	26	$11.42	$18.20	$38.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.56 / $48.72 / $106.75	Professional	TC	$30.56	$48.72	$106.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $37.85 / $65.44	Professional		$13.64	$37.85	$65.44
United Facility/Professional Professional Modifier Low / Median / High Price $35.53 / $48.30 / $85.35	Professional		$35.53	$48.30	$85.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $14.04 / $25.44	Professional	26	$9.93	$14.04	$25.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.31 / $33.89 / $59.25	Professional	TC	$24.31	$33.89	$59.25