Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.75 / $14.02 / $23.90	Facility	26	$12.75	$14.02	$23.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.29 / $50.67 / $369.30	Facility	TC	$33.29	$50.67	$369.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.91 / $54.25 / $146.86	Professional		$42.91	$54.25	$146.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.02 / $39.56	Professional	26	$12.59	$14.02	$39.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $35.79 / $89.60	Professional	TC	$30.85	$35.79	$89.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $85.84 / $130.47	Professional		$40.13	$85.84	$130.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.49 / $19.68 / $29.68	Professional	26	$10.49	$19.68	$29.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.69 / $28.69 / $29.34	Professional	TC	$28.69	$28.69	$29.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.35 / $37.35 / $37.35	Professional		$37.35	$37.35	$37.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.16 / $34.11 / $42.73	Professional	26	$23.16	$34.11	$42.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.27 / $64.95 / $91.80	Professional	TC	$51.27	$64.95	$91.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $78.05 / $132.46	Professional		$47.71	$78.05	$132.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $23.49 / $40.29	Professional	26	$15.47	$23.49	$40.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.82 / $53.90 / $93.30	Professional	TC	$32.82	$53.90	$93.30
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.34 / $33.90 / $43.57	Facility	26	$23.34	$33.90	$43.57
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $45.93 / $46.86 / $81.40	Facility	TC	$45.93	$46.86	$81.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $42.00 / $69.25	Professional		$19.00	$42.00	$69.25
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $103.88 / $103.88 / $287.20	Professional	50	$103.88	$103.88	$287.20
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $46.86 / $46.86 / $139.32	Professional	TC	$46.86	$46.86	$139.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $51.93 / $91.34	Professional		$14.98	$51.93	$91.34
United Facility/Professional Professional Modifier Low / Median / High Price $46.25 / $63.53 / $121.24	Professional		$46.25	$63.53	$121.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $20.05 / $37.35	Professional	26	$14.41	$20.05	$37.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.18 / $46.81 / $82.98	Professional	TC	$32.18	$46.81	$82.98
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 Facility Modifier TC Low / Median / High Price $84.96 / $219.36 / $219.36	Facility	TC	$84.96	$219.36	$219.36
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $345.18 / $453.53 / $453.53	Professional		$345.18	$453.53	$453.53
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $89.67 / $112.88 / $112.88	Professional	26	$89.67	$112.88	$112.88
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $255.46 / $340.65 / $340.65	Professional	TC	$255.46	$340.65	$340.65