Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.64 / $11.75 / $18.98	Facility	26	$10.64	$11.75	$18.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $38.36 / $119.62	Professional		$35.67	$38.36	$119.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.64 / $30.33	Professional	26	$10.23	$10.64	$30.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $27.71 / $78.95	Professional	TC	$25.05	$27.71	$78.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.38 / $32.53 / $32.53	Professional		$32.38	$32.53	$32.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $9.03 / $22.01	Professional	26	$9.03	$9.03	$22.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.88 / $30.88 / $30.88	Professional		$30.88	$30.88	$30.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.75 / $26.86 / $35.57	Professional	26	$18.75	$26.86	$35.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.88 / $51.49 / $70.13	Professional	TC	$36.88	$51.49	$70.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $61.28 / $103.53	Professional		$36.42	$61.28	$103.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $19.17 / $33.68	Professional	26	$11.28	$19.17	$33.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.48 / $41.20 / $74.20	Professional	TC	$24.48	$41.20	$74.20
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.00 / $21.00 / $36.00	Facility	26	$18.00	$21.00	$36.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $31.00 / $52.89	Professional		$16.00	$31.00	$52.89
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $18.00 / $18.00 / $21.00	Professional	26	$18.00	$18.00	$21.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $113.31 / $113.31 / $113.31	Professional	TC	$113.31	$113.31	$113.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.62 / $51.20 / $86.70	Professional		$17.62	$51.20	$86.70
United Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $58.99 / $101.03	Professional		$36.77	$58.99	$101.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.05 / $17.20 / $33.77	Professional	26	$12.05	$17.20	$33.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $36.65 / $68.03	Professional	TC	$24.72	$36.65	$68.03
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	26	$34.36	$100.00	$100.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $282.36 / $282.36 / $366.83	Professional		$282.36	$282.36	$366.83
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $90.81 / $90.81 / $96.90	Professional	26	$90.81	$90.81	$96.90
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $211.00 / $211.00 / $269.93	Professional	TC	$211.00	$211.00	$269.93