Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $18.54 / $38.65	Facility	26	$7.59	$18.54	$38.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.38 / $30.60 / $85.06	Professional		$19.38	$30.60	$85.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $9.92 / $23.83	Professional	26	$7.38	$9.92	$23.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $130.00 / $130.00 / $130.00	Professional	50	$130.00	$130.00	$130.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.74 / $19.46 / $54.57	Professional	TC	$11.74	$19.46	$54.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.79 / $21.32 / $39.65	Professional		$15.79	$21.32	$39.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $11.00 / $15.57	Professional	26	$6.74	$11.00	$15.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $37.09 / $68.04	Professional		$23.13	$37.09	$68.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $11.83 / $23.22	Professional	26	$7.81	$11.83	$23.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.70 / $55.69 / $102.06	Professional	50	$34.70	$55.69	$102.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.75 / $23.95 / $43.99	Professional	TC	$14.75	$23.95	$43.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.84 / $18.41 / $30.10	Professional		$8.84	$18.41	$30.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.06 / $44.07 / $72.98	Professional		$25.06	$44.07	$72.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $14.01 / $23.46	Professional	26	$8.30	$14.01	$23.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.12 / $29.24 / $46.79	Professional	TC	$18.12	$29.24	$46.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $40.89 / $104.89	Professional		$25.65	$40.89	$104.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $14.80 / $31.97	Professional	26	$9.27	$14.80	$31.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $16.37 / $27.78 / $77.11	Professional	TC	$16.37	$27.78	$77.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.84 / $19.22 / $43.25	Professional		$8.84	$19.22	$43.25
United Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $36.60 / $62.96	Professional		$25.77	$36.60	$62.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $11.65 / $19.53	Professional	26	$7.98	$11.65	$19.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $24.06 / $40.15	Professional	TC	$16.89	$24.06	$40.15