Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.57 / $31.90 / $63.90	Facility	26	$12.57	$31.90	$63.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.47 / $75.26 / $187.12	Professional		$50.47	$75.26	$187.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $17.91 / $42.93	Professional	26	$12.50	$17.91	$42.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.25 / $51.21 / $115.41	Professional	TC	$37.25	$51.21	$115.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $48.13 / $77.48	Professional		$39.93	$48.13	$77.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $14.04 / $26.55	Professional	26	$11.82	$14.04	$26.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $81.56 / $149.44	Professional		$57.11	$81.56	$149.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $22.36 / $40.79	Professional	26	$13.86	$22.36	$40.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.47 / $58.47 / $110.51	Professional	TC	$41.47	$58.47	$110.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.96 / $49.66 / $90.86	Professional		$14.96	$49.66	$90.86
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 $57.26 / $96.80 / $164.28	Professional		$57.26	$96.80	$164.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $25.84 / $42.22	Professional	26	$15.86	$25.84	$42.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.18 / $71.75 / $124.68	Professional	TC	$43.18	$71.75	$124.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.45 / $104.34 / $218.75	Professional		$65.45	$104.34	$218.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $26.75 / $57.80	Professional	26	$15.73	$26.75	$57.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $49.71 / $79.25 / $172.85	Professional	TC	$49.71	$79.25	$172.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $62.47 / $104.82	Professional		$19.39	$62.47	$104.82
United Facility/Professional Professional Modifier Low / Median / High Price $57.26 / $84.24 / $131.97	Professional		$57.26	$84.24	$131.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.94 / $21.47 / $35.29	Professional	26	$14.94	$21.47	$35.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.35 / $56.86 / $97.96	Professional	TC	$42.35	$56.86	$97.96