Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.04 / $7.25 / $11.07	Facility	26	$6.04	$7.25	$11.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.15 / $123.28 / $986.82	Facility	TC	$24.15	$123.28	$986.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $43.45 / $136.44	Professional		$26.88	$43.45	$136.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $9.22 / $33.64	Professional	26	$5.83	$9.22	$33.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.31 / $38.79 / $204.06	Professional	50	$37.31	$38.79	$204.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.03 / $16.30 / $35.45	Professional	52	$15.03	$16.30	$35.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.69 / $32.61 / $81.06	Professional	TC	$23.69	$32.61	$81.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.52 / $51.24 / $84.00	Professional		$23.52	$51.24	$84.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.97 / $10.26 / $16.89	Professional	26	$4.97	$10.26	$16.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $76.86 / $76.86 / $76.86	Professional	50	$76.86	$76.86	$76.86
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $12.81 / $12.81 / $12.81	Professional	52	$12.81	$12.81	$12.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $36.57 / $42.29	Professional	TC	$23.23	$36.57	$42.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $16.20 / $16.20	Professional		$16.20	$16.20	$16.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $14.02 / $18.82	Professional	26	$9.64	$14.02	$18.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.75 / $42.56 / $68.12	Professional	TC	$26.75	$42.56	$68.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.84 / $47.44 / $87.27	Professional		$26.84	$47.44	$87.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $10.54 / $18.63	Professional	26	$5.99	$10.54	$18.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.46 / $37.50 / $71.52	Professional	TC	$18.46	$37.50	$71.52
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $9.69 / $11.00 / $19.77	Facility	26	$9.69	$11.00	$19.77
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $30.82 / $46.14 / $79.03	Facility	TC	$30.82	$46.14	$79.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $9.00 / $30.00 / $43.00	Professional		$9.00	$30.00	$43.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $9.69 / $11.00	Professional	26	$9.69	$9.69	$11.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $60.11 / $64.50 / $199.93	Professional	50	$60.11	$64.50	$199.93
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $108.60 / $108.60 / $108.60	Professional	TC	$108.60	$108.60	$108.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.02 / $36.79 / $64.42	Professional		$7.02	$36.79	$64.42
United Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $43.51 / $83.60	Professional		$26.59	$43.51	$83.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.24 / $17.32	Professional	26	$6.55	$9.24	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.08 / $33.83 / $65.40	Professional	TC	$21.08	$33.83	$65.40
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $67.18 / $173.52 / $173.52	Facility	TC	$67.18	$173.52	$173.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $241.48 / $241.48 / $324.52	Professional		$241.48	$241.48	$324.52
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $51.19 / $51.19 / $54.60	Professional	26	$51.19	$51.19	$54.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $199.06 / $199.06 / $269.93	Professional	TC	$199.06	$199.06	$269.93