Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.49 / $11.15 / $68.78	Facility	26	$9.49	$11.15	$68.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.57 / $54.91 / $109.18	Professional		$35.57	$54.91	$109.18
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $90.40 / $90.40 / $90.40	Professional	25	$90.40	$90.40	$90.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $12.37 / $28.28	Professional	26	$9.49	$12.37	$28.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.26 / $38.22 / $72.20	Professional	TC	$27.26	$38.22	$72.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $60.22 / $72.27	Professional		$34.40	$60.22	$72.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $13.94 / $18.11	Professional	26	$9.56	$13.94	$18.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.84 / $75.42 / $120.99	Professional		$37.84	$75.42	$120.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $18.64 / $31.34	Professional	26	$9.66	$18.64	$31.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $55.70 / $88.88	Professional	TC	$27.87	$55.70	$88.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.83 / $30.97 / $48.07	Professional		$9.83	$30.97	$48.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.42 / $77.89 / $115.79	Professional		$47.42	$77.89	$115.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $18.36 / $30.57	Professional	26	$11.51	$18.36	$30.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.10 / $57.54 / $85.99	Professional	TC	$36.10	$57.54	$85.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.84 / $49.19 / $141.11	Professional		$37.84	$49.19	$141.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $12.66 / $88.90	Professional	26	$9.74	$12.66	$88.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $36.53 / $141.11	Professional	TC	$28.10	$36.53	$141.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $35.11 / $62.26	Professional		$10.45	$35.11	$62.26
United Facility/Professional Professional Modifier Low / Median / High Price $50.94 / $72.51 / $108.31	Professional		$50.94	$72.51	$108.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $17.26 / $26.02	Professional	26	$11.69	$17.26	$26.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.00 / $54.31 / $84.28	Professional	TC	$39.00	$54.31	$84.28