Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.93 / $15.16 / $65.38	Facility	26	$12.93	$15.16	$65.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $54.75 / $130.50	Professional		$34.22	$54.75	$130.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $13.64 / $42.37	Professional	26	$7.78	$13.64	$42.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.54 / $34.45 / $110.31	Professional	TC	$21.54	$34.45	$110.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $25.82 / $27.24	Professional	26	$12.09	$25.82	$27.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $68.08 / $132.36	Professional		$41.15	$68.08	$132.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $15.68 / $34.56	Professional	26	$9.34	$15.68	$34.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $46.76 / $102.16	Professional	TC	$26.92	$46.76	$102.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.13 / $33.25 / $54.65	Professional		$15.13	$33.25	$54.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $84.43 / $163.21	Professional		$43.86	$84.43	$163.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $16.68 / $40.52	Professional	26	$9.16	$16.68	$40.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.69 / $67.02 / $148.44	Professional	TC	$31.69	$67.02	$148.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $82.29 / $249.60	Professional		$45.98	$82.29	$249.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $22.57 / $53.95	Professional	26	$16.14	$22.57	$53.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $54.26 / $227.03	Professional	TC	$29.84	$54.26	$227.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.75 / $42.83 / $76.45	Professional		$16.75	$42.83	$76.45
United Facility/Professional Professional Modifier Low / Median / High Price $41.94 / $69.13 / $132.54	Professional		$41.94	$69.13	$132.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $15.87 / $33.82	Professional	26	$8.99	$15.87	$33.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.90 / $48.13 / $109.15	Professional	TC	$25.90	$48.13	$109.15