Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.19 / $40.70 / $121.83	Facility	26	$24.19	$40.70	$121.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $79.58 / $170.44	Professional		$47.87	$79.58	$170.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $29.39 / $69.93	Professional	26	$23.34	$29.39	$69.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $33.61 / $111.94	Professional	TC	$22.09	$33.61	$111.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.74 / $98.55 / $109.39	Professional		$45.74	$98.55	$109.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $38.78 / $49.44	Professional	26	$20.39	$38.78	$49.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.50 / $40.96 / $57.15	Professional	TC	$29.50	$40.96	$57.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $93.28 / $170.27	Professional		$53.02	$93.28	$170.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $36.86 / $63.38	Professional	26	$24.48	$36.86	$63.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.29 / $48.04 / $109.53	Professional	TC	$28.29	$48.04	$109.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.39 / $40.02 / $76.11	Professional		$27.39	$40.02	$76.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $111.59 / $200.01	Professional		$58.89	$111.59	$200.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.33 / $41.54 / $72.51	Professional	26	$27.33	$41.54	$72.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.40 / $60.35 / $133.96	Professional	TC	$29.40	$60.35	$133.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.92 / $76.29 / $228.60	Professional		$58.92	$76.29	$228.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.63 / $34.61 / $83.82	Professional	26	$26.63	$34.61	$83.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $40.10 / $228.60	Professional	TC	$32.29	$40.10	$228.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.65 / $50.75 / $108.29	Professional		$29.65	$50.75	$108.29
United Facility/Professional Professional Modifier Low / Median / High Price $55.73 / $97.05 / $171.01	Professional		$55.73	$97.05	$171.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $37.06 / $64.87	Professional	26	$28.11	$37.06	$64.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.41 / $51.44 / $109.12	Professional	TC	$29.41	$51.44	$109.12