Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.83 / $16.46 / $25.06	Facility	26	$11.83	$16.46	$25.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.49 / $70.06 / $188.46	Professional		$46.49	$70.06	$188.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $14.50 / $38.08	Professional	26	$11.69	$14.50	$38.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $38.79 / $102.67	Professional	TC	$33.61	$38.79	$102.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.20 / $52.92 / $129.54	Professional		$39.20	$52.92	$129.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $19.94 / $33.18	Professional	26	$9.78	$19.94	$33.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.41 / $31.25 / $54.81	Professional	TC	$29.41	$31.25	$54.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.78 / $38.78 / $38.78	Professional		$38.78	$38.78	$38.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.03 / $33.35 / $44.25	Professional	26	$23.03	$33.35	$44.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.71 / $70.09 / $92.86	Professional	TC	$51.71	$70.09	$92.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $75.42 / $132.40	Professional		$43.99	$75.42	$132.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $23.22 / $40.15	Professional	26	$13.87	$23.22	$40.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $53.60 / $94.76	Professional	TC	$33.15	$53.60	$94.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $22.50 / $31.00 / $42.00	Facility	26	$22.50	$31.00	$42.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $37.00 / $69.92	Professional		$20.00	$37.00	$69.92
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $22.50 / $31.00 / $48.43	Professional	26	$22.50	$31.00	$48.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.70 / $51.72 / $91.60	Professional		$13.70	$51.72	$91.60
United Facility/Professional Professional Modifier Low / Median / High Price $46.95 / $64.26 / $122.92	Professional		$46.95	$64.26	$122.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $20.35 / $41.77	Professional	26	$13.71	$20.35	$41.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $45.41 / $81.33	Professional	TC	$32.47	$45.41	$81.33
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $41.72 / $110.00 / $110.00	Facility	26	$41.72	$110.00	$110.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $343.08 / $343.08 / $453.98	Professional		$343.08	$343.08	$453.98
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $113.92 / $113.92 / $113.92	Professional	26	$113.92	$113.92	$113.92
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $259.85 / $259.85 / $349.13	Professional	TC	$259.85	$259.85	$349.13