Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $42.66 / $109.65	Facility	26	$19.95	$42.66	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $81.28 / $269.15	Professional		$39.81	$81.28	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $33.88 / $93.33	Professional	26	$19.05	$33.88	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.20 / $93.33	Professional	TC	$18.20	$30.20	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $72.44	Professional		$36.31	$42.66	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $25.12 / $43.65	Professional	26	$18.62	$25.12	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.99 / $29.51	Professional	TC	$17.78	$23.99	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $154.88	Professional		$52.48	$93.33	$154.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.18 / $44.67	Professional	26	$19.05	$28.18	$44.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $63.10 / $117.49	Professional	TC	$25.12	$63.10	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $57.54	Professional		$22.91	$30.90	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $89.13 / $169.82	Professional		$45.71	$89.13	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $30.90 / $56.23	Professional	26	$19.05	$30.90	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $53.70 / $131.83	Professional	TC	$22.91	$53.70	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $61.66 / $223.87	Professional		$52.48	$61.66	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $75.86	Professional	26	$23.99	$28.84	$75.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $204.17	Professional	TC	$28.18	$33.11	$204.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $79.43	Professional		$25.12	$42.66	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $79.43 / $134.90	Professional		$46.77	$79.43	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $27.54 / $51.29	Professional	26	$20.89	$27.54	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $39.81 / $100.00	Professional	TC	$22.39	$39.81	$100.00