Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.00 / $10.47 / $35.68	Facility	26	$7.00	$10.47	$35.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $34.88 / $93.08	Professional		$17.27	$34.88	$93.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $12.35 / $37.28	Professional	26	$7.00	$12.35	$37.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.56 / $155.13 / $181.08	Professional	50	$77.56	$155.13	$181.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $22.23 / $50.01	Professional	TC	$18.82	$22.23	$50.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.32 / $47.42 / $58.85	Professional		$21.32	$47.42	$58.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $11.31 / $14.90	Professional	26	$6.41	$11.31	$14.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.57 / $40.65 / $80.12	Professional	TC	$27.57	$40.65	$80.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $38.42 / $76.39	Professional		$25.85	$38.42	$76.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.35 / $10.92 / $21.41	Professional	26	$7.35	$10.92	$21.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.28 / $57.76 / $115.78	Professional	50	$38.28	$57.76	$115.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $27.58 / $57.60	Professional	TC	$18.14	$27.58	$57.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.16 / $26.25 / $48.19	Professional		$8.16	$26.25	$48.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $43.97 / $82.19	Professional		$25.93	$43.97	$82.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $12.87 / $21.67	Professional	26	$7.58	$12.87	$21.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.89 / $32.00 / $58.57	Professional	TC	$18.89	$32.00	$58.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $55.59 / $116.59	Professional		$34.86	$55.59	$116.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $13.68 / $29.53	Professional	26	$8.58	$13.68	$29.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.93 / $87.89	Professional	TC	$26.30	$41.93	$87.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $30.59 / $53.74	Professional		$8.18	$30.59	$53.74
United Facility/Professional Professional Modifier Low / Median / High Price $27.66 / $38.11 / $67.98	Professional		$27.66	$38.11	$67.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.40 / $19.00	Professional	26	$7.79	$10.40	$19.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $27.17 / $50.56	Professional	TC	$19.41	$27.17	$50.56