Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $14.54 / $49.03	Facility	26	$9.34	$14.54	$49.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.38 / $38.69 / $140.50	Professional		$31.38	$38.69	$140.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $11.77 / $26.58	Professional	26	$8.63	$11.77	$26.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $27.37 / $70.80	Professional	TC	$22.08	$27.37	$70.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $50.36 / $66.33	Professional		$29.52	$50.36	$66.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $17.66 / $19.27	Professional	26	$8.88	$17.66	$19.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.17 / $49.17 / $49.17	Professional	TC	$49.17	$49.17	$49.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $46.14 / $92.83	Professional		$32.11	$46.14	$92.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $13.28 / $28.38	Professional	26	$9.34	$13.28	$28.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.48 / $32.13 / $66.92	Professional	TC	$22.48	$32.13	$66.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.98 / $30.51 / $55.95	Professional		$10.98	$30.51	$55.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.58 / $54.00 / $97.12	Professional		$31.58	$54.00	$97.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $15.58 / $28.20	Professional	26	$9.14	$15.58	$28.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.25 / $38.59 / $70.76	Professional	TC	$23.25	$38.59	$70.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $66.92 / $140.29	Professional		$41.98	$66.92	$140.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $18.20 / $38.19	Professional	26	$11.42	$18.20	$38.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.56 / $48.72 / $102.15	Professional	TC	$30.56	$48.72	$102.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $40.02 / $70.59	Professional		$14.53	$40.02	$70.59
United Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $44.05 / $81.81	Professional		$33.40	$44.05	$81.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $13.07 / $23.19	Professional	26	$9.52	$13.07	$23.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.24 / $31.98 / $58.29	Professional	TC	$23.24	$31.98	$58.29