Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $19.50 / $43.65	Facility	26	$12.88	$19.50	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $89.13 / $218.78	Professional		$52.48	$89.13	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $23.44 / $61.66	Professional	26	$12.02	$23.44	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $52.48 / $131.83	Professional	TC	$37.15	$52.48	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $104.71	Professional		$40.74	$56.23	$104.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.79 / $32.36	Professional	26	$10.96	$14.79	$32.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $48.98 / $81.28	Professional	TC	$32.36	$48.98	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $41.69 / $51.29	Professional	26	$23.44	$41.69	$51.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $79.43 / $120.23	Professional	TC	$63.10	$79.43	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.55 / $16.60 / $23.44	Facility	26	$3.55	$16.60	$23.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $89.13 / $154.88	Professional		$58.88	$89.13	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $25.12 / $43.65	Professional	26	$12.88	$25.12	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $64.57 / $114.82	Professional	TC	$39.81	$64.57	$114.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Professional	26	$32.36	$32.36	$32.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $63.10 / $128.82	Professional		$15.49	$63.10	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $131.83	Professional		$54.95	$72.44	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $20.42 / $37.15	Professional	26	$14.79	$20.42	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $93.33	Professional	TC	$38.90	$52.48	$93.33
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $524.81	Professional		$398.11	$398.11	$524.81
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $218.78	Professional	26	$138.04	$138.04	$218.78
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $407.38	Professional	TC	$354.81	$354.81	$407.38