Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.47 / $21.31 / $43.10	Facility	26	$8.47	$21.31	$43.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.33 / $28.76 / $86.25	Professional		$25.33	$28.76	$86.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $9.31 / $25.76	Professional	26	$8.26	$9.31	$25.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.64 / $19.57 / $54.46	Professional	TC	$15.64	$19.57	$54.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.46 / $15.46 / $15.46	Professional	26	$15.46	$15.46	$15.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $46.68 / $110.00	Professional		$28.66	$46.68	$110.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $13.40 / $26.28	Professional	26	$9.01	$13.40	$26.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $26.16 / $60.50	Professional	TC	$17.48	$26.16	$60.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.58 / $24.13 / $44.31	Professional		$9.58	$24.13	$44.31
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 $28.90 / $48.23 / $85.42	Professional		$28.90	$48.23	$85.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $16.79 / $27.51	Professional	26	$9.78	$16.79	$27.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.29 / $32.06 / $60.15	Professional	TC	$19.29	$32.06	$60.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $54.47 / $114.20	Professional		$34.17	$54.47	$114.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.94 / $38.14	Professional	26	$10.00	$15.94	$38.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $38.53 / $105.81	Professional	TC	$24.17	$38.53	$105.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.24 / $32.76 / $57.46	Professional		$13.24	$32.76	$57.46
United Facility/Professional Professional Modifier Low / Median / High Price $28.25 / $38.17 / $70.18	Professional		$28.25	$38.17	$70.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $13.36 / $22.44	Professional	26	$9.06	$13.36	$22.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $27.88 / $48.98	Professional	TC	$18.18	$27.88	$48.98