Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $22.39 / $42.66	Facility	26	$12.30	$22.39	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.02 / $95.50	Professional		$22.91	$38.02	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $30.20	Professional	26	$7.08	$10.00	$30.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $36.31 / $158.49	Professional	52	$30.20	$36.31	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $52.48	Professional	TC	$15.14	$22.91	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $40.74 / $53.70	Professional		$19.95	$40.74	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $10.47	Professional	26	$7.94	$7.94	$10.47
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $6.03 / $6.03 / $6.03	Professional	52	$6.03	$6.03	$6.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $36.31	Professional	TC	$36.31	$36.31	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $72.44	Professional		$31.62	$44.67	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.49 / $21.38	Professional	26	$9.55	$13.49	$21.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $51.29	Professional	TC	$22.39	$30.90	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $79.43	Professional		$28.84	$47.86	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $23.99	Professional	26	$9.12	$14.45	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.88 / $56.23	Professional	TC	$19.95	$33.88	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $104.71	Professional		$30.90	$39.81	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $32.36	Professional	26	$9.55	$12.59	$32.36
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $25.70 / $25.70 / $36.31	Professional	52	$25.70	$25.70	$36.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.18 / $97.72	Professional	TC	$21.38	$28.18	$97.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $28.18 / $50.12	Professional		$9.77	$28.18	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $39.81 / $70.79	Professional		$28.84	$39.81	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.75 / $21.38	Professional	26	$8.91	$11.75	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $50.12	Professional	TC	$19.95	$27.54	$50.12