Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $19.57 / $66.87	Facility	26	$13.15	$19.57	$66.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.07 / $50.85 / $134.57	Professional		$40.07	$50.85	$134.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $20.12 / $48.17	Professional	26	$13.15	$20.12	$48.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $34.03 / $71.42	Professional	TC	$26.96	$34.03	$71.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $82.23 / $90.10	Professional		$37.39	$82.23	$90.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.33 / $18.86 / $27.66	Professional	26	$12.33	$18.86	$27.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $61.36 / $121.28	Professional		$42.65	$61.36	$121.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.22 / $21.00 / $40.17	Professional	26	$14.22	$21.00	$40.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $39.35 / $81.68	Professional	TC	$26.62	$39.35	$81.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $36.89 / $67.59	Professional		$15.66	$36.89	$67.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $72.44 / $127.97	Professional		$42.78	$72.44	$127.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.59 / $24.58 / $42.32	Professional	26	$14.59	$24.58	$42.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.30 / $48.87 / $85.05	Professional	TC	$28.30	$48.87	$85.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $85.10 / $178.45	Professional		$53.38	$85.10	$178.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $26.22 / $63.33	Professional	26	$16.45	$26.22	$63.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.94 / $58.89 / $123.50	Professional	TC	$36.94	$58.89	$123.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $50.37 / $90.69	Professional		$21.53	$50.37	$90.69
United Facility/Professional Professional Modifier Low / Median / High Price $44.11 / $60.25 / $107.50	Professional		$44.11	$60.25	$107.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $19.82 / $34.59	Professional	26	$14.23	$19.82	$34.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.75 / $40.54 / $70.45	Professional	TC	$28.75	$40.54	$70.45