Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $17.38 / $50.12	Facility	26	$9.33	$17.38	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $151.36	Professional		$30.90	$45.71	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $14.79 / $30.20	Professional	26	$8.13	$14.79	$30.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $63.10	Professional	TC	$19.95	$28.84	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $35.48 / $66.07	Professional		$29.51	$35.48	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.59 / $19.50	Professional	26	$8.71	$12.59	$19.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $52.48	Professional	TC	$22.39	$26.30	$52.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $75.86	Professional		$32.36	$42.66	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.30 / $21.88	Professional	26	$9.33	$12.30	$21.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $54.95	Professional	TC	$22.91	$30.20	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $30.20 / $47.86	Professional		$10.96	$30.20	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $93.33	Professional		$30.90	$48.98	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.45 / $25.70	Professional	26	$8.91	$14.45	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $35.48 / $67.61	Professional	TC	$22.39	$35.48	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $120.23	Professional		$39.81	$51.29	$120.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.80 / $34.67	Professional	26	$10.47	$13.80	$34.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $37.15 / $91.20	Professional	TC	$28.84	$37.15	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $31.62 / $64.57	Professional		$10.96	$31.62	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $77.62	Professional		$32.36	$42.66	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $22.39	Professional	26	$9.12	$12.30	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $56.23	Professional	TC	$22.91	$30.20	$56.23