Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $22.39 / $70.79	Facility	26	$12.88	$22.39	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $37.15 / $83.18	Professional		$17.78	$37.15	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $52.48	Professional	26	$10.00	$16.98	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $23.44 / $53.70	Professional	TC	$10.96	$23.44	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Professional		$28.18	$28.18	$28.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $19.05 / $26.92	Professional	26	$11.75	$19.05	$26.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $36.31	Professional	TC	$36.31	$36.31	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.84 / $64.57	Professional		$17.78	$28.84	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.75 / $25.70	Professional	26	$7.76	$11.75	$25.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $16.98 / $40.74	Professional	TC	$9.77	$16.98	$40.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $29.51 / $52.48	Professional		$15.49	$29.51	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.88 / $102.33	Professional		$19.05	$33.88	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.49 / $35.48	Professional	26	$8.32	$13.49	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $19.50 / $66.07	Professional	TC	$10.00	$19.50	$66.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $109.65	Professional		$43.65	$52.48	$109.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.50 / $38.02	Professional	26	$14.79	$19.50	$38.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $70.79	Professional	TC	$28.84	$34.67	$70.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $33.11 / $74.13	Professional		$15.49	$33.11	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $39.81 / $81.28	Professional		$21.38	$39.81	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.49 / $31.62	Professional	26	$8.32	$15.49	$31.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $26.30 / $54.95	Professional	TC	$12.02	$26.30	$54.95