Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.88 / $10.30 / $40.13	Facility	26	$7.88	$10.30	$40.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.57 / $82.11 / $204.27	Facility	TC	$19.57	$82.11	$204.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $31.40 / $83.63	Professional		$21.73	$31.40	$83.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.46 / $28.15	Professional	26	$7.78	$9.46	$28.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.02 / $20.32 / $52.75	Professional	TC	$18.02	$20.32	$52.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $39.69 / $60.06	Professional		$24.88	$39.69	$60.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $12.28 / $16.75	Professional	26	$7.34	$12.28	$16.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $36.95 / $77.17	Professional		$27.77	$36.95	$77.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $11.68 / $21.76	Professional	26	$8.69	$11.68	$21.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.45 / $26.84 / $56.04	Professional	TC	$18.45	$26.84	$56.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.21 / $25.90 / $47.56	Professional		$9.21	$25.90	$47.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $45.84 / $84.12	Professional		$28.74	$45.84	$84.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $14.49 / $24.77	Professional	26	$9.22	$14.49	$24.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $32.09 / $59.66	Professional	TC	$19.32	$32.09	$59.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $56.73 / $289.00	Professional		$35.59	$56.73	$289.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $15.38 / $92.48	Professional	26	$9.65	$15.38	$92.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.94 / $41.35 / $196.52	Professional	TC	$25.94	$41.35	$196.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.31 / $33.96 / $56.69	Professional		$12.31	$33.96	$56.69
United Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $38.31 / $68.68	Professional		$28.58	$38.31	$68.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.98 / $12.23 / $20.76	Professional	26	$8.98	$12.23	$20.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.60 / $26.52 / $48.98	Professional	TC	$19.60	$26.52	$48.98