Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.74 / $43.25 / $105.51	Facility	26	$20.74	$43.25	$105.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $48.78 / $128.63	Professional		$37.14	$48.78	$128.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $24.88 / $66.76	Professional	26	$20.05	$24.88	$66.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.14 / $22.78 / $58.18	Professional	TC	$16.14	$22.78	$58.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $47.70 / $76.97	Professional		$33.79	$47.70	$76.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $31.84 / $42.09	Professional	26	$19.04	$31.84	$42.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $24.02 / $33.97	Professional	TC	$24.02	$24.02	$33.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.20 / $63.34 / $130.82	Professional		$40.20	$63.34	$130.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.98 / $31.62 / $56.33	Professional	26	$20.98	$31.62	$56.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $28.75 / $73.23	Professional	TC	$18.03	$28.75	$73.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $30.16 / $55.64	Professional		$19.36	$30.16	$55.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.14 / $76.33 / $139.16	Professional		$45.14	$76.33	$139.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.30 / $35.36 / $62.98	Professional	26	$24.30	$35.36	$62.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.68 / $36.03 / $68.61	Professional	TC	$20.68	$36.03	$68.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $55.51 / $242.29	Professional		$42.70	$55.51	$242.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $29.47 / $75.55	Professional	26	$22.67	$29.47	$75.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $24.91 / $214.71	Professional	TC	$20.04	$24.91	$214.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $33.76 / $70.65	Professional		$18.16	$33.76	$70.65
United Facility/Professional Professional Modifier Low / Median / High Price $44.46 / $66.61 / $117.71	Professional		$44.46	$66.61	$117.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $31.20 / $53.18	Professional	26	$23.94	$31.20	$53.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $31.97 / $69.59	Professional	TC	$19.77	$31.97	$69.59