Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.11 / $10.11 / $23.60	Facility	26	$10.11	$10.11	$23.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.74 / $35.68 / $120.80	Professional		$29.74	$35.68	$120.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $12.94 / $28.97	Professional	26	$10.11	$12.94	$28.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.62 / $21.58 / $37.39	Professional	TC	$19.62	$21.58	$37.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $28.18 / $161.72	Professional		$26.94	$28.18	$161.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $17.71 / $19.21	Professional	26	$14.60	$17.71	$19.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $48.23 / $68.26	Professional		$29.53	$48.23	$68.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $18.76 / $25.05	Professional	26	$10.31	$18.76	$25.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.45 / $33.72 / $43.87	Professional	TC	$19.45	$33.72	$43.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.59 / $22.56 / $39.13	Professional		$10.59	$22.56	$39.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $47.47 / $90.12	Professional		$33.00	$47.47	$90.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $18.76 / $32.97	Professional	26	$12.52	$18.76	$32.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.36 / $29.90 / $53.57	Professional	TC	$20.36	$29.90	$53.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $48.67 / $251.00	Professional		$32.40	$48.67	$251.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $16.63 / $102.91	Professional	26	$11.07	$16.63	$102.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $32.04 / $148.09	Professional	TC	$21.33	$32.04	$148.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.10 / $82.10 / $82.10	Professional		$82.10	$82.10	$82.10
United Facility/Professional Professional Modifier Low / Median / High Price $35.35 / $50.66 / $84.59	Professional		$35.35	$50.66	$84.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $18.77 / $28.74	Professional	26	$12.99	$18.77	$28.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.25 / $30.18 / $51.20	Professional	TC	$21.25	$30.18	$51.20