Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.35 / $23.21 / $47.54	Facility	26	$9.35	$23.21	$47.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $46.61 / $117.17	Professional		$32.70	$46.61	$117.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.21 / $29.19	Professional	26	$9.11	$11.21	$29.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $36.57 / $76.23	Professional	TC	$23.44	$36.57	$76.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.53 / $33.53 / $66.52	Professional		$33.53	$33.53	$66.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $14.57 / $19.82	Professional	26	$7.97	$14.57	$19.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.88 / $45.88 / $45.88	Professional	TC	$45.88	$45.88	$45.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $56.46 / $101.17	Professional		$39.14	$56.46	$101.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $14.54 / $29.32	Professional	26	$10.11	$14.54	$29.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $39.61 / $77.16	Professional	TC	$27.21	$39.61	$77.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $31.93 / $58.56	Professional		$10.96	$31.93	$58.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $65.00 / $109.61	Professional		$37.86	$65.00	$109.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.85 / $28.85	Professional	26	$10.23	$17.85	$28.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.67 / $47.99 / $86.22	Professional	TC	$28.67	$47.99	$86.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.40 / $69.18 / $145.06	Professional		$43.40	$69.18	$145.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $18.20 / $39.38	Professional	26	$11.42	$18.20	$39.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.98 / $50.98 / $123.12	Professional	TC	$31.98	$50.98	$123.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.07 / $40.70 / $70.45	Professional		$14.07	$40.70	$70.45
United Facility/Professional Professional Modifier Low / Median / High Price $38.06 / $55.36 / $91.39	Professional		$38.06	$55.36	$91.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $14.04 / $25.32	Professional	26	$9.93	$14.04	$25.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $39.83 / $71.59	Professional	TC	$27.08	$39.83	$71.59