Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.16 / $11.97 / $41.61	Facility	26	$8.16	$11.97	$41.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $64.81 / $176.81	Professional		$30.97	$64.81	$176.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $9.92 / $27.85	Professional	26	$7.99	$9.92	$27.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $48.30 / $130.43	Professional	TC	$22.35	$48.30	$130.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $46.74 / $67.54	Professional		$29.29	$46.74	$67.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $12.80 / $16.88	Professional	26	$7.66	$12.80	$16.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $51.45 / $51.45	Professional	TC	$26.55	$51.45	$51.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.53 / $67.03 / $172.91	Professional		$37.53	$67.03	$172.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $12.77 / $26.24	Professional	26	$8.77	$12.77	$26.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.16 / $42.66 / $149.93	Professional	TC	$26.16	$42.66	$149.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.58 / $31.93 / $58.35	Professional		$9.58	$31.93	$58.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $88.12 / $207.53	Professional		$39.61	$88.12	$207.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $16.22 / $26.66	Professional	26	$9.75	$16.22	$26.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.27 / $71.20 / $154.63	Professional	TC	$30.27	$71.20	$154.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.98 / $66.92 / $288.18	Professional		$41.98	$66.92	$288.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.94 / $49.92	Professional	26	$10.00	$15.94	$49.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.98 / $50.98 / $288.18	Professional	TC	$31.98	$50.98	$288.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.24 / $42.84 / $70.67	Professional		$13.24	$42.84	$70.67
United Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $61.77 / $125.01	Professional		$36.04	$61.77	$125.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $11.90 / $21.53	Professional	26	$8.59	$11.90	$21.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.76 / $48.55 / $98.55	Professional	TC	$27.76	$48.55	$98.55