Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $30.20 / $61.66	Facility	26	$11.48	$30.20	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $64.57 / $154.88	Professional		$38.90	$64.57	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $38.90	Professional	26	$10.96	$14.13	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $42.66 / $109.65	Professional	TC	$32.36	$42.66	$109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $83.18 / $109.65	Professional		$53.70	$83.18	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.59 / $23.44	Professional	26	$10.47	$12.59	$23.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	TC	$52.48	$52.48	$52.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $102.33	Professional		$47.86	$63.10	$102.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $17.38 / $26.30	Professional	26	$13.80	$17.38	$26.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $95.50 / $158.49	Professional	50	$72.44	$95.50	$158.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $45.71 / $77.62	Professional	TC	$33.88	$45.71	$77.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $50.12 / $74.13	Professional		$13.80	$50.12	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $74.13 / $144.54	Professional		$47.86	$74.13	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $20.42 / $35.48	Professional	26	$11.75	$20.42	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $54.95 / $112.20	Professional	TC	$35.48	$54.95	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $269.15	Professional		$64.57	$83.18	$269.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.78 / $75.86	Professional	26	$13.49	$17.78	$75.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $66.07 / $194.98	Professional	TC	$50.12	$66.07	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $58.88 / $104.71	Professional		$14.45	$58.88	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $120.23	Professional		$50.12	$64.57	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $29.51	Professional	26	$12.59	$16.60	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $46.77 / $89.13	Professional	TC	$36.31	$46.77	$89.13