Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.39 / $11.39 / $20.52	Facility	26	$11.39	$11.39	$20.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $40.39 / $61.55	Professional		$34.71	$40.39	$61.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.49 / $12.45 / $17.36	Professional	26	$10.49	$12.45	$17.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $27.47 / $41.85	Professional	TC	$23.72	$27.47	$41.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $41.11 / $41.11	Professional		$41.11	$41.11	$41.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.70 / $58.90 / $103.03	Professional		$38.70	$58.90	$103.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $18.14 / $30.49	Professional	26	$11.23	$18.14	$30.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $40.74 / $68.23	Professional	TC	$26.10	$40.74	$68.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.08 / $11.08 / $11.08	Professional		$11.08	$11.08	$11.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.71 / $57.73 / $107.50	Professional		$41.71	$57.73	$107.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $17.42 / $31.76	Professional	26	$12.78	$17.42	$31.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.67 / $40.19 / $68.34	Professional	TC	$28.67	$40.19	$68.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $55.90 / $191.00	Professional		$43.00	$55.90	$191.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $15.18 / $55.39	Professional	26	$11.68	$15.18	$55.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $40.72 / $135.61	Professional	TC	$31.32	$40.72	$135.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.51 / $38.72 / $67.28	Professional		$12.51	$38.72	$67.28
United Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $52.25 / $85.61	Professional		$36.11	$52.25	$85.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $16.14 / $25.26	Professional	26	$11.42	$16.14	$25.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.80 / $36.27 / $61.02	Professional	TC	$24.80	$36.27	$61.02