Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.64 / $11.64 / $49.03	Facility	26	$9.64	$11.64	$49.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.91 / $211.57 / $638.28	Facility	TC	$21.91	$211.57	$638.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $45.78 / $93.89	Professional		$30.19	$45.78	$93.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $14.91 / $34.13	Professional	26	$9.57	$14.91	$34.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $23.61 / $59.20	Professional	TC	$19.89	$23.61	$59.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $32.04 / $66.65	Professional		$24.18	$32.04	$66.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $15.04 / $21.85	Professional	26	$8.86	$15.04	$21.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.51 / $41.51 / $111.18	Professional	TC	$41.51	$41.51	$111.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $41.06 / $85.73	Professional		$31.12	$41.06	$85.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.17 / $14.26 / $25.02	Professional	26	$10.17	$14.26	$25.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.98 / $29.08 / $60.71	Professional	TC	$19.98	$29.08	$60.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.31 / $27.68 / $50.77	Professional		$11.31	$27.68	$50.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $52.31 / $94.60	Professional		$32.70	$52.31	$94.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $17.69 / $30.41	Professional	26	$11.27	$17.69	$30.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.04 / $34.65 / $64.62	Professional	TC	$21.04	$34.65	$64.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.71 / $43.08 / $132.02	Professional		$33.71	$43.08	$132.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $15.42 / $39.36	Professional	26	$11.78	$15.42	$39.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.72 / $36.29 / $92.65	Professional	TC	$27.72	$36.29	$92.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.60 / $37.13 / $64.62	Professional		$14.60	$37.13	$64.62
United Facility/Professional Professional Modifier Low / Median / High Price $32.75 / $43.94 / $77.65	Professional		$32.75	$43.94	$77.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $14.95 / $25.37	Professional	26	$10.95	$14.95	$25.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.36 / $28.89 / $52.86	Professional	TC	$21.36	$28.89	$52.86