Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.86 / $5.01 / $11.01	Facility	26	$2.86	$5.01	$11.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.14 / $39.83 / $135.06	Professional		$23.14	$39.83	$135.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.72 / $3.56 / $9.60	Professional	26	$2.72	$3.56	$9.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.06 / $11.94 / $64.69	Professional	52	$11.06	$11.94	$64.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $25.83 / $90.00	Professional	TC	$20.07	$25.83	$90.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.66 / $38.83 / $53.24	Professional		$18.66	$38.83	$53.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.06 / $5.40 / $6.85	Professional	26	$3.06	$5.40	$6.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.84 / $45.91 / $170.99	Professional		$21.84	$45.91	$170.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.89 / $5.17 / $9.84	Professional	26	$2.89	$5.17	$9.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $38.45 / $158.47	Professional	TC	$19.03	$38.45	$158.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.03 / $19.36 / $30.69	Professional		$3.03	$19.36	$30.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $47.66 / $151.96	Professional		$25.91	$47.66	$151.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.61 / $5.22 / $8.66	Professional	26	$3.61	$5.22	$8.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $40.29 / $135.12	Professional	TC	$23.10	$40.29	$135.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.13 / $32.90 / $262.27	Professional		$24.13	$32.90	$262.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $3.20 / $4.37 / $11.08	Professional	26	$3.20	$4.37	$11.08
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $17.44 / $17.44 / $63.76	Professional	52	$17.44	$17.44	$63.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.93 / $28.55 / $262.27	Professional	TC	$20.93	$28.55	$262.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.84 / $31.05 / $44.51	Professional		$4.84	$31.05	$44.51
United Facility/Professional Professional Modifier Low / Median / High Price $24.50 / $42.87 / $133.63	Professional		$24.50	$42.87	$133.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.23 / $4.66 / $8.77	Professional	26	$3.23	$4.66	$8.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.14 / $32.90 / $122.86	Professional	TC	$21.14	$32.90	$122.86