Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $23.44 / $50.12	Facility	26	$9.33	$23.44	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $158.49	Professional		$32.36	$46.77	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $35.48	Professional	26	$8.91	$14.13	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $74.13	Professional	TC	$21.88	$33.11	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $40.74 / $81.28	Professional		$25.12	$40.74	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $18.62	Professional	26	$9.33	$15.14	$18.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $53.70	Professional	TC	$23.99	$30.20	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $54.95 / $93.33	Professional		$42.66	$54.95	$93.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $25.12	Professional	26	$10.72	$14.45	$25.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $39.81 / $69.18	Professional	TC	$30.20	$39.81	$69.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $31.62 / $50.12	Professional		$10.96	$31.62	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $61.66 / $104.71	Professional		$35.48	$61.66	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.22 / $27.54	Professional	26	$9.77	$16.22	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $45.71 / $77.62	Professional	TC	$27.54	$45.71	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $144.54	Professional		$42.66	$56.23	$144.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $38.02	Professional	26	$10.72	$14.45	$38.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $41.69 / $123.03	Professional	TC	$31.62	$41.69	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $39.81 / $69.18	Professional		$11.22	$39.81	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $91.20	Professional		$38.02	$51.29	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $23.44	Professional	26	$10.00	$12.88	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $66.07	Professional	TC	$26.92	$38.02	$66.07