Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $9.12 / $12.02	Facility	26	$8.13	$9.12	$12.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $131.83	Professional		$51.29	$66.07	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $22.91	Professional	26	$7.94	$10.00	$22.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $100.00	Professional	TC	$42.66	$52.48	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $100.00	Professional		$46.77	$60.26	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $16.98	Professional	26	$8.32	$10.72	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	TC	$75.86	$75.86	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $107.15	Professional		$57.54	$77.62	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $16.60	Professional	26	$8.91	$13.18	$16.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $64.57 / $91.20	Professional	TC	$47.86	$64.57	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $48.98 / $67.61	Professional		$8.51	$48.98	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $134.90	Professional		$56.23	$75.86	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $21.88	Professional	26	$9.12	$12.30	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $64.57 / $114.82	Professional	TC	$46.77	$64.57	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $173.78	Professional		$61.66	$77.62	$173.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $26.92	Professional	26	$8.91	$11.48	$26.92
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $41.69 / $41.69 / $61.66	Professional	52	$41.69	$41.69	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $66.07 / $147.91	Professional	TC	$52.48	$66.07	$147.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $75.86 / $125.89	Professional		$13.80	$75.86	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $114.82	Professional		$48.98	$67.61	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.72 / $18.20	Professional	26	$8.13	$10.72	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $57.54 / $95.50	Professional	TC	$40.74	$57.54	$95.50