Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.81 / $12.33 / $56.44	Facility	26	$10.81	$12.33	$56.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.57 / $44.49 / $153.16	Professional		$34.57	$44.49	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.57 / $15.66 / $34.72	Professional	26	$10.57	$15.66	$34.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $26.09 / $66.22	Professional	TC	$23.17	$26.09	$66.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $42.20 / $67.72	Professional		$32.06	$42.20	$67.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $15.70 / $24.48	Professional	26	$10.38	$15.70	$24.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.36 / $47.76 / $100.56	Professional		$36.36	$47.76	$100.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $16.35 / $29.57	Professional	26	$11.90	$16.35	$29.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $33.90 / $70.81	Professional	TC	$23.38	$33.90	$70.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.69 / $32.64 / $59.81	Professional		$12.69	$32.64	$59.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.77 / $59.50 / $108.99	Professional		$37.77	$59.50	$108.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.11 / $20.41 / $34.75	Professional	26	$13.11	$20.41	$34.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.50 / $40.61 / $75.05	Professional	TC	$24.50	$40.61	$75.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.15 / $53.19 / $153.36	Professional		$27.15	$53.19	$153.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.20 / $21.04 / $46.68	Professional	26	$13.20	$21.04	$46.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.15 / $37.99 / $109.24	Professional	TC	$27.15	$37.99	$109.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.28 / $41.86 / $72.95	Professional		$16.28	$41.86	$72.95
United Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $51.11 / $92.48	Professional		$37.46	$51.11	$92.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.86 / $29.28	Professional	26	$12.59	$16.86	$29.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.87 / $34.15 / $62.34	Professional	TC	$24.87	$34.15	$62.34