Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $40.97 / $101.02	Facility	26	$20.14	$40.97	$101.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $52.83 / $157.43	Professional		$31.46	$52.83	$157.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.69 / $33.24 / $66.34	Professional	26	$19.69	$33.24	$66.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.23 / $25.54 / $105.57	Professional	TC	$12.23	$25.54	$105.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $54.58 / $54.58	Professional		$54.58	$54.58	$54.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $33.63 / $42.82	Professional	26	$19.05	$33.63	$42.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $72.84 / $145.12	Professional		$37.92	$72.84	$145.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.47 / $32.69 / $65.88	Professional	26	$22.47	$32.69	$65.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $38.77 / $92.00	Professional	TC	$16.48	$38.77	$92.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.82 / $33.31 / $85.23	Professional		$15.82	$33.31	$85.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.62 / $108.17 / $168.10	Professional		$57.62	$108.17	$168.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.81 / $44.97 / $72.56	Professional	26	$25.81	$44.97	$72.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.41 / $52.77 / $109.67	Professional	TC	$28.41	$52.77	$109.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $69.86 / $213.63	Professional		$43.82	$69.86	$213.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.69 / $40.95 / $73.20	Professional	26	$25.69	$40.95	$73.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $28.92 / $213.63	Professional	TC	$18.14	$28.92	$213.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.75 / $38.11 / $71.63	Professional		$23.75	$38.11	$71.63
United Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $83.59 / $123.52	Professional		$48.29	$83.59	$123.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.06 / $31.35 / $57.64	Professional	26	$24.06	$31.35	$57.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.39 / $43.98 / $71.29	Professional	TC	$21.39	$43.98	$71.29