Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.40 / $12.98 / $57.97	Facility	26	$11.40	$12.98	$57.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $55.07 / $142.32	Professional		$43.38	$55.07	$142.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.13 / $13.40 / $36.44	Professional	26	$11.13	$13.40	$36.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.76 / $39.95 / $99.09	Professional	TC	$32.76	$39.95	$99.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.78 / $74.54 / $98.90	Professional		$54.78	$74.54	$98.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $14.79 / $24.85	Professional	26	$10.37	$14.79	$24.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $67.12 / $140.12	Professional		$48.18	$67.12	$140.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $17.64 / $32.11	Professional	26	$12.54	$17.64	$32.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.27 / $100.68 / $210.18	Professional	50	$72.27	$100.68	$210.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.38 / $52.42 / $109.66	Professional	TC	$34.38	$52.42	$109.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $50.36 / $89.81	Professional		$13.56	$50.36	$89.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $80.94 / $150.44	Professional		$50.14	$80.94	$150.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.99 / $21.98 / $37.46	Professional	26	$13.99	$21.98	$37.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $60.35 / $112.30	Professional	TC	$36.97	$60.35	$112.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.73 / $103.20 / $303.00	Professional		$64.73	$103.20	$303.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.31 / $22.81 / $84.84	Professional	26	$14.31	$22.81	$84.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.42 / $80.39 / $218.16	Professional	TC	$50.42	$80.39	$218.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.21 / $63.87 / $103.68	Professional		$18.21	$63.87	$103.68
United Facility/Professional Professional Modifier Low / Median / High Price $50.75 / $67.88 / $123.48	Professional		$50.75	$67.88	$123.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $18.10 / $30.44	Professional	26	$13.09	$18.10	$30.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.21 / $52.02 / $93.22	Professional	TC	$37.21	$52.02	$93.22