Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $16.98 / $43.65	Facility	26	$11.22	$16.98	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $57.54 / $138.04	Professional		$37.15	$57.54	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $18.62 / $43.65	Professional	26	$10.00	$18.62	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $95.50	Professional	TC	$25.70	$36.31	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $48.98 / $114.82	Professional		$33.88	$48.98	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.75 / $19.05	Professional	26	$9.33	$11.75	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.12 / $33.11	Professional	TC	$20.42	$25.12	$33.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Professional		$32.36	$32.36	$32.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $28.84 / $38.02	Professional	26	$17.78	$28.84	$38.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $56.23 / $81.28	Professional	TC	$44.67	$56.23	$81.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $64.57 / $114.82	Professional		$39.81	$64.57	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.62 / $33.88	Professional	26	$10.96	$18.62	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $45.71 / $81.28	Professional	TC	$27.54	$45.71	$81.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Professional	26	$22.39	$22.39	$22.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $165.96	Professional		$47.86	$83.18	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $95.50	Professional		$39.81	$52.48	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $28.18	Professional	26	$12.02	$15.85	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $66.07	Professional	TC	$26.92	$36.31	$66.07
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $389.05	Professional		$309.03	$309.03	$389.05
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $100.00	Professional	26	$95.50	$95.50	$100.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $251.19 / $295.12	Professional	TC	$251.19	$251.19	$295.12