Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $25.12 / $56.23	Facility	26	$10.47	$25.12	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $107.15	Professional		$33.11	$52.48	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.45 / $33.11	Professional	26	$9.77	$14.45	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $63.10	Professional	TC	$20.89	$30.20	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $53.70 / $81.28	Professional		$30.20	$53.70	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $22.39	Professional	26	$10.72	$15.49	$22.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $33.88 / $38.02	Professional	TC	$26.92	$33.88	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $50.12 / $117.49	Professional		$37.15	$50.12	$117.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $26.30	Professional	26	$10.72	$14.45	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $34.67 / $61.66	Professional	TC	$26.30	$34.67	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $31.62 / $51.29	Professional		$12.30	$31.62	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $100.00	Professional		$33.88	$53.70	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $28.84	Professional	26	$10.00	$16.60	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $70.79	Professional	TC	$24.55	$39.81	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $57.54 / $138.04	Professional		$44.67	$57.54	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.22 / $39.81	Professional	26	$12.59	$16.22	$39.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $40.74 / $100.00	Professional	TC	$31.62	$40.74	$100.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $34.67 / $72.44	Professional		$12.88	$34.67	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $46.77 / $87.10	Professional		$35.48	$46.77	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.80 / $25.70	Professional	26	$10.47	$13.80	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $60.26	Professional	TC	$24.55	$33.11	$60.26