Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.38 / $16.80 / $25.58	Facility	26	$13.38	$16.80	$25.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $59.21 / $219.02	Professional		$51.49	$59.21	$219.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.33 / $15.01 / $43.02	Professional	26	$13.33	$15.01	$43.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $40.14 / $120.56	Professional	TC	$37.11	$40.14	$120.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $98.35 / $98.35	Professional		$45.92	$98.35	$98.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.19 / $12.87 / $31.61	Professional	26	$11.19	$12.87	$31.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $39.97 / $39.97	Professional		$39.97	$39.97	$39.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $36.51 / $45.73	Professional	26	$24.78	$36.51	$45.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.65 / $85.82 / $110.22	Professional	TC	$61.65	$85.82	$110.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $89.20 / $152.71	Professional		$55.32	$89.20	$152.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $25.15 / $42.27	Professional	26	$16.14	$25.15	$42.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.08 / $64.83 / $110.58	Professional	TC	$39.08	$64.83	$110.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.97 / $35.43 / $46.67	Facility	26	$23.97	$35.43	$46.67
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $50.00 / $80.00	Professional		$20.00	$50.00	$80.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $54.72 / $54.72 / $54.72	Professional	26	$54.72	$54.72	$54.72
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $56.36 / $56.36 / $56.36	Professional	TC	$56.36	$56.36	$56.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $59.01 / $102.87	Professional		$15.65	$59.01	$102.87
United Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $75.11 / $148.43	Professional		$53.69	$75.11	$148.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.68 / $22.07 / $41.96	Professional	26	$15.68	$22.07	$41.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.03 / $56.30 / $98.66	Professional	TC	$39.03	$56.30	$98.66
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $73.77 / $73.77	Facility	26	$50.00	$73.77	$73.77
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $395.03 / $522.08 / $522.08	Professional		$395.03	$522.08	$522.08
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $93.99 / $122.10 / $122.10	Professional	26	$93.99	$122.10	$122.10
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $301.02 / $400.05 / $400.05	Professional	TC	$301.02	$400.05	$400.05