Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.63 / $15.01 / $25.58	Facility	26	$13.63	$15.01	$25.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.45 / $72.68 / $194.35	Professional		$57.45	$72.68	$194.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.32 / $64.00	Professional	26	$13.49	$15.32	$64.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $49.64 / $114.37	Professional	TC	$42.39	$49.64	$114.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $111.46 / $170.49	Professional		$52.22	$111.46	$170.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $16.22 / $31.61	Professional	26	$11.44	$16.22	$31.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.06 / $74.06 / $74.06	Professional	TC	$74.06	$74.06	$74.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $39.97 / $39.97	Professional		$39.97	$39.97	$39.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $36.36 / $45.73	Professional	26	$24.78	$36.36	$45.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.39 / $89.18 / $125.74	Professional	TC	$70.39	$89.18	$125.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $94.25 / $171.86	Professional		$54.11	$94.25	$171.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $25.15 / $42.98	Professional	26	$16.14	$25.15	$42.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.08 / $74.34 / $130.21	Professional	TC	$45.08	$74.34	$130.21
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.97 / $23.97 / $38.40	Facility	26	$23.97	$23.97	$38.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $57.00 / $88.30	Professional		$20.00	$57.00	$88.30
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $23.97 / $23.97	Professional	26	$23.97	$23.97	$23.97
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $194.86 / $194.86 / $194.86	Professional	TC	$194.86	$194.86	$194.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.73 / $67.09 / $117.88	Professional		$15.73	$67.09	$117.88
United Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $90.23 / $166.06	Professional		$60.68	$90.23	$166.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.76 / $22.07 / $41.60	Professional	26	$15.76	$22.07	$41.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.97 / $64.90 / $113.63	Professional	TC	$44.97	$64.90	$113.63
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $73.77 / $73.77	Facility	26	$50.00	$73.77	$73.77
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $453.03 / $592.79 / $592.79	Professional		$453.03	$592.79	$592.79
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $122.10 / $122.10	Professional	26	$95.54	$122.10	$122.10
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $357.49 / $470.78 / $470.78	Professional	TC	$357.49	$470.78	$470.78