Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.47 / $29.60 / $63.41	Facility	26	$16.47	$29.60	$63.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.40 / $64.27 / $168.68	Professional		$49.40	$64.27	$168.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $20.48 / $59.63	Professional	26	$16.47	$20.48	$59.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.54 / $41.17 / $101.44	Professional	TC	$32.54	$41.17	$101.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.22 / $90.05 / $92.64	Professional		$41.22	$90.05	$92.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.71 / $32.18 / $39.72	Professional	26	$21.71	$32.18	$39.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.43 / $89.58 / $166.65	Professional		$47.43	$89.58	$166.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $29.42 / $55.98	Professional	26	$16.71	$29.42	$55.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.20 / $62.01 / $116.29	Professional	TC	$31.20	$62.01	$116.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.41 / $36.15 / $63.72	Professional		$17.41	$36.15	$63.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.10 / $20.10 / $20.10	Facility	26	$20.10	$20.10	$20.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.41 / $92.77 / $167.39	Professional		$56.41	$92.77	$167.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $28.82 / $53.72	Professional	26	$19.78	$28.82	$53.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.44 / $63.91 / $118.47	Professional	TC	$37.44	$63.91	$118.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.35 / $72.75 / $218.02	Professional		$53.35	$72.75	$218.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $25.28 / $79.75	Professional	26	$18.54	$25.28	$79.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $47.48 / $218.02	Professional	TC	$34.82	$47.48	$218.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.01 / $55.07 / $96.61	Professional		$27.01	$55.07	$96.61
United Facility/Professional Professional Modifier Low / Median / High Price $54.41 / $91.20 / $156.46	Professional		$54.41	$91.20	$156.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $25.61 / $46.67	Professional	26	$18.23	$25.61	$46.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.94 / $56.25 / $105.04	Professional	TC	$33.94	$56.25	$105.04