Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $30.90 / $72.44	Facility	26	$12.88	$30.90	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $234.42	Professional		$56.23	$81.28	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $22.39 / $69.18	Professional	26	$12.02	$22.39	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $53.70 / $123.03	Professional	TC	$38.90	$53.70	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $67.61 / $128.82	Professional		$46.77	$67.61	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $21.38 / $28.18	Professional	26	$12.02	$21.38	$28.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $54.95 / $194.98	Professional	TC	$51.29	$54.95	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $123.03	Professional		$57.54	$75.86	$123.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.50 / $30.20	Professional	26	$15.85	$19.50	$30.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $56.23 / $93.33	Professional	TC	$41.69	$56.23	$93.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $58.88 / $85.11	Professional		$15.49	$58.88	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $89.13 / $165.96	Professional		$56.23	$89.13	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $22.91 / $40.74	Professional	26	$13.18	$22.91	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $67.61 / $131.83	Professional	TC	$43.65	$67.61	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $316.23	Professional		$72.44	$95.50	$316.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.95 / $83.18	Professional	26	$15.14	$19.95	$83.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $75.86 / $234.42	Professional	TC	$57.54	$75.86	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $67.61 / $120.23	Professional		$15.85	$67.61	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $77.62 / $144.54	Professional		$60.26	$77.62	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.50 / $33.88	Professional	26	$14.79	$19.50	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $57.54 / $109.65	Professional	TC	$45.71	$57.54	$109.65