Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.07 / $17.21 / $26.16	Facility	26	$13.07	$17.21	$26.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.07 / $69.00 / $209.25	Professional		$54.07	$69.00	$209.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $16.17 / $41.65	Professional	26	$13.01	$16.17	$41.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.34 / $48.08 / $106.84	Professional	TC	$40.34	$48.08	$106.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $59.40 / $83.37	Professional		$45.41	$59.40	$83.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.02 / $22.65 / $29.28	Professional	26	$11.02	$22.65	$29.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.47 / $33.47 / $73.23	Professional	TC	$33.47	$33.47	$73.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $46.35 / $46.35	Professional		$46.35	$46.35	$46.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $37.77 / $48.31	Professional	26	$27.46	$37.77	$48.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.55 / $92.68 / $130.63	Professional	TC	$66.55	$92.68	$130.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $101.07 / $164.62	Professional		$62.42	$101.07	$164.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.84 / $27.01 / $42.67	Professional	26	$15.84	$27.01	$42.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.63 / $74.56 / $120.69	Professional	TC	$43.63	$74.56	$120.69
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.10 / $30.00 / $46.73	Facility	26	$26.10	$30.00	$46.73
Medcost Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $57.00 / $79.00	Professional		$21.00	$57.00	$79.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $26.48 / $30.00 / $53.43	Professional	26	$26.48	$30.00	$53.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.32 / $61.70 / $103.37	Professional		$15.32	$61.70	$103.37
United Facility/Professional Professional Modifier Low / Median / High Price $57.26 / $82.69 / $153.38	Professional		$57.26	$82.69	$153.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.13 / $21.21 / $42.64	Professional	26	$15.13	$21.21	$42.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.85 / $60.73 / $112.03	Professional	TC	$41.85	$60.73	$112.03
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $126.00 / $126.00	Facility	26	$49.08	$126.00	$126.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $399.42 / $399.42 / $516.67	Professional		$399.42	$399.42	$516.67
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $151.90 / $151.90 / $151.90	Professional	26	$151.90	$151.90	$151.90
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $307.58 / $307.58 / $397.20	Professional	TC	$307.58	$307.58	$397.20