Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.89 / $12.30 / $31.62	Facility	26	$5.89	$12.30	$31.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $91.20 / $446.68	Facility	TC	$25.70	$91.20	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $41.69 / $112.20	Professional		$14.45	$41.69	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $11.48 / $31.62	Professional	26	$5.89	$11.48	$31.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $97.72 / $316.23	Professional	50	$34.67	$97.72	$316.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.47 / $72.44 / $158.49	Professional	52	$10.47	$72.44	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $34.67 / $72.44	Professional	TC	$22.39	$34.67	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $35.48 / $64.57	Professional		$25.70	$35.48	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $7.94 / $12.30	Professional	26	$5.25	$7.94	$12.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $57.54 / $95.50	Professional	50	$43.65	$57.54	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $34.67 / $58.88	Professional	TC	$24.55	$34.67	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.90 / $67.61	Professional		$25.12	$38.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.91 / $15.14	Professional	26	$6.46	$8.91	$15.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $58.88 / $100.00	Professional	50	$38.02	$58.88	$100.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $29.51 / $53.70	Professional	TC	$17.38	$29.51	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $33.11 / $46.77	Professional		$6.76	$33.11	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $91.20	Professional		$26.92	$44.67	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $9.55 / $17.38	Professional	26	$5.89	$9.55	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $34.67 / $75.86	Professional	TC	$20.89	$34.67	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $114.82	Professional		$39.81	$52.48	$114.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $9.12 / $23.99	Professional	26	$6.76	$9.12	$23.99
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $33.88 / $33.88 / $47.86	Professional	52	$33.88	$33.88	$47.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $43.65 / $89.13	Professional	TC	$33.11	$43.65	$89.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $33.88 / $66.07	Professional		$6.92	$33.88	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $70.79	Professional		$26.92	$38.02	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.94 / $14.45	Professional	26	$5.89	$7.94	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $57.54	Professional	TC	$19.50	$30.90	$57.54