Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $23.44 / $56.23	Facility	26	$10.72	$23.44	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $158.49	Professional		$40.74	$67.61	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $52.48	Professional	26	$10.96	$20.89	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $44.67 / $85.11	Professional	TC	$30.20	$44.67	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $87.10	Professional		$34.67	$46.77	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $21.88	Professional	26	$10.00	$14.79	$21.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $35.48 / $66.07	Professional	TC	$27.54	$35.48	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $63.10 / $107.15	Professional		$48.98	$63.10	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.50 / $32.36	Professional	26	$13.80	$19.50	$32.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $44.67 / $79.43	Professional	TC	$33.88	$44.67	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $41.69 / $63.10	Professional		$12.88	$41.69	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $123.03	Professional		$41.69	$72.44	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.89 / $35.48	Professional	26	$12.88	$20.89	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $51.29 / $93.33	Professional	TC	$30.90	$51.29	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $177.83	Professional		$54.95	$70.79	$177.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $53.70	Professional	26	$12.88	$17.38	$53.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $53.70 / $138.04	Professional	TC	$41.69	$53.70	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $50.12 / $89.13	Professional		$13.49	$50.12	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $107.15	Professional		$46.77	$60.26	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.98 / $30.20	Professional	26	$12.30	$16.98	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $42.66 / $77.62	Professional	TC	$33.11	$42.66	$77.62