Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $18.32 / $39.29	Facility	26	$15.49	$18.32	$39.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $68.64 / $155.68	Professional		$61.64	$68.64	$155.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.91 / $15.61 / $42.02	Professional	26	$14.91	$15.61	$42.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $53.15 / $109.00	Professional	TC	$46.00	$53.15	$109.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $126.82 / $126.82	Professional		$59.33	$126.82	$126.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $23.05 / $28.05	Professional	26	$17.30	$23.05	$28.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $84.12 / $84.12 / $84.12	Professional	TC	$84.12	$84.12	$84.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $43.55 / $43.55	Professional		$43.55	$43.55	$43.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.87 / $39.77 / $51.17	Professional	26	$27.87	$39.77	$51.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.41 / $97.61 / $147.21	Professional	TC	$76.41	$97.61	$147.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $110.53 / $187.98	Professional		$67.09	$110.53	$187.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.10 / $27.43 / $48.63	Professional	26	$18.10	$27.43	$48.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.09 / $83.31 / $145.91	Professional	TC	$50.09	$83.31	$145.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.12 / $26.12 / $42.24	Facility	26	$26.12	$26.12	$42.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $62.00 / $95.95	Professional		$22.00	$62.00	$95.95
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $26.12 / $26.12	Professional	26	$26.12	$26.12	$26.12
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $217.30 / $217.30 / $217.30	Professional	TC	$217.30	$217.30	$217.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $81.39 / $131.18	Professional		$18.00	$81.39	$131.18
United Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $99.93 / $170.33	Professional		$67.48	$99.93	$170.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $25.53 / $43.58	Professional	26	$17.79	$25.53	$43.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.59 / $72.27 / $131.08	Professional	TC	$49.59	$72.27	$131.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $84.60 / $84.60	Facility	26	$50.00	$84.60	$84.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $507.76 / $673.88 / $673.88	Professional		$507.76	$673.88	$673.88
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $109.02 / $136.88 / $136.88	Professional	26	$109.02	$136.88	$136.88
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $398.67 / $537.00 / $537.00	Professional	TC	$398.67	$537.00	$537.00