Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.29 / $18.07 / $37.15	Facility	26	$7.29	$18.07	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $38.25 / $99.37	Professional		$30.51	$38.25	$99.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.49 / $23.60	Professional	26	$7.08	$9.49	$23.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.10 / $55.00 / $55.00	Professional	50	$39.10	$55.00	$55.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.71 / $65.56	Professional	TC	$22.26	$27.71	$65.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.27 / $66.93 / $72.04	Professional		$31.27	$66.93	$72.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $10.56 / $14.29	Professional	26	$6.78	$10.56	$14.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.00 / $52.00 / $52.00	Professional	TC	$52.00	$52.00	$52.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $44.77 / $93.48	Professional		$29.46	$44.77	$93.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $11.43 / $22.42	Professional	26	$7.73	$11.43	$22.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.19 / $67.16 / $140.22	Professional	50	$44.19	$67.16	$140.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.96 / $35.67 / $74.69	Professional	TC	$21.96	$35.67	$74.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.49 / $33.70 / $59.13	Professional		$8.49	$33.70	$59.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $51.39 / $97.96	Professional		$29.53	$51.39	$97.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $14.09 / $22.58	Professional	26	$8.23	$14.09	$22.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $37.82 / $78.67	Professional	TC	$21.01	$37.82	$78.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.68 / $65.78 / $142.66	Professional		$42.68	$65.78	$142.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $14.24 / $30.77	Professional	26	$8.93	$14.24	$30.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.75 / $53.80 / $112.82	Professional	TC	$33.75	$53.80	$112.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.75 / $40.24 / $69.84	Professional		$9.75	$40.24	$69.84
United Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $44.38 / $86.14	Professional		$30.51	$44.38	$86.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.31 / $19.53	Professional	26	$7.95	$11.31	$19.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $33.35 / $66.34	Professional	TC	$21.81	$33.35	$66.34