Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.54 / $9.35 / $28.22	Facility	26	$5.54	$9.35	$28.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.28 / $55.41 / $280.72	Facility	TC	$19.28	$55.41	$280.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $32.65 / $100.06	Professional		$21.28	$32.65	$100.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $8.36 / $24.00	Professional	26	$5.53	$8.36	$24.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.02 / $24.29 / $59.62	Professional	TC	$18.02	$24.29	$59.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.64 / $44.42 / $48.71	Professional		$21.64	$44.42	$48.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $8.25 / $12.61	Professional	26	$5.09	$8.25	$12.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.20 / $36.20 / $89.04	Professional	TC	$36.20	$36.20	$89.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.16 / $34.97 / $68.61	Professional		$24.16	$34.97	$68.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.85 / $8.61 / $17.01	Professional	26	$5.85	$8.61	$17.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $25.93 / $53.46	Professional	TC	$16.92	$25.93	$53.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.44 / $24.13 / $42.97	Professional		$6.44	$24.13	$42.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $40.58 / $73.08	Professional		$23.39	$40.58	$73.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.06 / $10.18 / $17.18	Professional	26	$6.06	$10.18	$17.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $31.92 / $57.18	Professional	TC	$17.78	$31.92	$57.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $49.36 / $103.53	Professional		$30.97	$49.36	$103.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $10.84 / $23.36	Professional	26	$6.80	$10.84	$23.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $38.53 / $80.80	Professional	TC	$24.17	$38.53	$80.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.93 / $29.65 / $53.09	Professional		$8.93	$29.65	$53.09
United Facility/Professional Professional Modifier Low / Median / High Price $25.61 / $35.15 / $60.66	Professional		$25.61	$35.15	$60.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $8.13 / $14.60	Professional	26	$5.94	$8.13	$14.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $26.46 / $46.09	Professional	TC	$18.71	$26.46	$46.09