Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.83 / $14.95 / $22.75	Facility	26	$11.83	$14.95	$22.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $56.34 / $139.19	Professional		$46.93	$56.34	$139.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $12.78 / $36.63	Professional	26	$11.40	$12.78	$36.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $39.56 / $101.94	Professional	TC	$34.14	$39.56	$101.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $9.86 / $14.79	Professional	26	$9.81	$9.86	$14.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $35.54 / $35.54	Professional		$35.54	$35.54	$35.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $32.46 / $40.67	Professional	26	$22.04	$32.46	$40.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.73 / $72.47 / $101.51	Professional	TC	$56.73	$72.47	$101.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.89 / $78.06 / $142.18	Professional		$45.89	$78.06	$142.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $22.35 / $37.46	Professional	26	$14.39	$22.35	$37.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.74 / $61.92 / $105.58	Professional	TC	$37.74	$61.92	$105.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.32 / $21.32 / $32.71	Facility	26	$21.32	$21.32	$32.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $46.00 / $73.17	Professional		$18.00	$46.00	$73.17
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $21.32 / $21.32	Professional	26	$21.32	$21.32	$21.32
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $109.76 / $109.76 / $315.30	Professional	50	$109.76	$109.76	$315.30
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $161.77 / $161.77 / $161.77	Professional	TC	$161.77	$161.77	$161.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.31 / $59.56 / $104.85	Professional		$14.31	$59.56	$104.85
United Facility/Professional Professional Modifier Low / Median / High Price $49.35 / $68.40 / $128.10	Professional		$49.35	$68.40	$128.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $19.22 / $35.54	Professional	26	$13.64	$19.22	$35.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.20 / $50.95 / $93.25	Professional	TC	$36.20	$50.95	$93.25
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $379.94 / $511.80 / $511.80	Professional		$379.94	$511.80	$511.80
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $83.23 / $108.90 / $108.90	Professional	26	$83.23	$108.90	$108.90
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $296.70 / $402.90 / $402.90	Professional	TC	$296.70	$402.90	$402.90