Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.37 / $27.13 / $57.93	Facility	26	$11.37	$27.13	$57.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $42.69 / $124.69	Professional		$34.04	$42.69	$124.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $14.87 / $38.10	Professional	26	$11.06	$14.87	$38.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.63 / $19.27 / $46.32	Professional	52	$16.63	$19.27	$46.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.26 / $60.72	Professional	TC	$22.26	$27.26	$60.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.69 / $63.22 / $84.06	Professional		$39.69	$63.22	$84.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $18.42 / $22.33	Professional	26	$10.65	$18.42	$22.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $50.78 / $110.56	Professional		$37.04	$50.78	$110.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $17.63 / $34.79	Professional	26	$11.95	$17.63	$34.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.21 / $36.14 / $75.47	Professional	TC	$23.21	$36.14	$75.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.20 / $34.40 / $63.06	Professional		$13.20	$34.40	$63.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $61.62 / $114.90	Professional		$36.79	$61.62	$114.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $22.01 / $36.36	Professional	26	$12.72	$22.01	$36.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $39.79 / $76.91	Professional	TC	$23.82	$39.79	$76.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.41 / $77.18 / $161.82	Professional		$48.41	$77.18	$161.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $22.25 / $50.39	Professional	26	$13.96	$22.25	$50.39
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $40.31 / $40.31 / $56.64	Professional	52	$40.31	$40.31	$56.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.45 / $54.92 / $115.19	Professional	TC	$34.45	$54.92	$115.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.28 / $46.64 / $82.24	Professional		$18.28	$46.64	$82.24
United Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $50.81 / $95.23	Professional		$38.18	$50.81	$95.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $17.68 / $30.84	Professional	26	$12.19	$17.68	$30.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $33.50 / $67.16	Professional	TC	$25.41	$33.50	$67.16