Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.42 / $13.14 / $32.67	Facility	26	$6.42	$13.14	$32.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $11.97 / $30.59 / $56.40	Facility	TC	$11.97	$30.59	$56.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.17 / $22.39 / $59.22	Professional		$16.17	$22.39	$59.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.33 / $7.70 / $21.63	Professional	26	$6.33	$7.70	$21.63
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.06 / $108.38 / $197.13	Professional	50	$99.06	$108.38	$197.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.98 / $14.78 / $38.22	Professional	TC	$10.98	$14.78	$38.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.43 / $21.57 / $39.10	Professional		$15.43	$21.57	$39.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $6.89 / $13.27	Professional	26	$5.72	$6.89	$13.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.62 / $24.62 / $24.62	Professional	TC	$24.62	$24.62	$24.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $30.23 / $54.94	Professional		$20.87	$30.23	$54.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $10.00 / $19.63	Professional	26	$6.83	$10.00	$19.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $31.30 / $45.80 / $85.73	Professional	50	$31.30	$45.80	$85.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.79 / $19.52 / $37.61	Professional	TC	$13.79	$19.52	$37.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $16.14 / $28.15	Professional		$7.48	$16.14	$28.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.51 / $34.72 / $58.30	Professional		$19.51	$34.72	$58.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $12.22 / $19.98	Professional	26	$7.05	$12.22	$19.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.32 / $22.19 / $39.04	Professional	TC	$14.32	$22.19	$39.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $36.93 / $80.16	Professional		$23.17	$36.93	$80.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $12.54 / $28.30	Professional	26	$7.87	$12.54	$28.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.30 / $25.10 / $69.20	Professional	TC	$15.30	$25.10	$69.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.21 / $20.71 / $37.90	Professional		$10.21	$20.71	$37.90
United Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $28.99 / $50.79	Professional		$20.57	$28.99	$50.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $9.52 / $16.95	Professional	26	$6.95	$9.52	$16.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.26 / $19.50 / $30.93	Professional	TC	$13.26	$19.50	$30.93