Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.52 / $21.90 / $53.48	Facility	26	$10.52	$21.90	$53.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $43.57 / $104.71	Professional		$33.15	$43.57	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $12.55 / $29.89	Professional	26	$9.80	$12.55	$29.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $30.15 / $69.09	Professional	TC	$23.17	$30.15	$69.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $68.86 / $75.64	Professional		$41.85	$68.86	$75.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.09 / $19.09 / $21.69	Professional	26	$10.09	$19.09	$21.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $52.28 / $112.94	Professional		$35.22	$52.28	$112.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $14.95 / $32.32	Professional	26	$10.51	$14.95	$32.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.33 / $36.34 / $77.09	Professional	TC	$25.33	$36.34	$77.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $31.93 / $58.56	Professional		$12.34	$31.93	$58.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.44 / $61.57 / $104.54	Professional		$35.44	$61.57	$104.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $17.64 / $31.62	Professional	26	$10.38	$17.64	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.11 / $45.13 / $75.37	Professional	TC	$26.11	$45.13	$75.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.81 / $71.44 / $149.79	Professional		$44.81	$71.44	$149.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.85 / $20.48 / $42.92	Professional	26	$12.85	$20.48	$42.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.98 / $50.98 / $106.89	Professional	TC	$31.98	$50.98	$106.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.84 / $42.78 / $75.37	Professional		$16.84	$42.78	$75.37
United Facility/Professional Professional Modifier Low / Median / High Price $35.46 / $53.40 / $90.11	Professional		$35.46	$53.40	$90.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $14.61 / $25.98	Professional	26	$10.38	$14.61	$25.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.29 / $35.34 / $61.64	Professional	TC	$25.29	$35.34	$61.64