Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.71 / $11.74 / $17.87	Facility	26	$9.71	$11.74	$17.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.60 / $360.34 / $779.10	Facility	TC	$30.60	$360.34	$779.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $54.01 / $189.90	Professional		$30.79	$54.01	$189.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $15.53 / $51.00	Professional	26	$9.71	$15.53	$51.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.40 / $87.92 / $242.16	Professional	50	$44.40	$87.92	$242.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.80 / $20.16 / $34.47	Professional	52	$16.80	$20.16	$34.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.76 / $47.15 / $140.08	Professional	TC	$28.76	$47.15	$140.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $64.34 / $111.00	Professional		$35.15	$64.34	$111.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $12.31 / $27.20	Professional	26	$8.26	$12.31	$27.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.55 / $52.55 / $85.41	Professional	50	$52.55	$52.55	$85.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.84 / $48.84 / $78.14	Professional	TC	$48.84	$48.84	$78.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.65 / $28.65 / $28.65	Professional		$28.65	$28.65	$28.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $24.64 / $31.58	Professional	26	$16.39	$24.64	$31.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.90 / $56.51 / $78.34	Professional	TC	$37.90	$56.51	$78.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $12.66	Facility	26	$12.66	$12.66	$12.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.63 / $40.63 / $40.63	Facility	TC	$40.63	$40.63	$40.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $65.06 / $110.99	Professional		$37.11	$65.06	$110.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $17.42 / $30.67	Professional	26	$9.88	$17.42	$30.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.74 / $46.04 / $83.08	Professional	TC	$25.74	$46.04	$83.08
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.26 / $19.00 / $32.07	Facility	26	$16.26	$19.00	$32.07
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $39.01 / $59.89 / $89.92	Facility	TC	$39.01	$59.89	$89.92
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $35.00 / $54.17	Professional		$14.00	$35.00	$54.17
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $19.00 / $39.71	Professional	26	$16.26	$19.00	$39.71
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $81.26 / $99.00 / $247.24	Professional	50	$81.26	$99.00	$247.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.92 / $48.17 / $82.13	Professional		$14.92	$48.17	$82.13
United Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $56.35 / $109.20	Professional		$37.06	$56.35	$109.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $14.90 / $27.93	Professional	26	$10.88	$14.90	$27.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $40.31 / $78.55	Professional	TC	$25.57	$40.31	$78.55
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $100.00 / $100.00	Facility	26	$29.45	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $77.14 / $199.17 / $199.17	Facility	TC	$77.14	$199.17	$199.17
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $297.63 / $297.63 / $398.70	Professional		$297.63	$297.63	$398.70
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $87.52 / $89.18	Professional	26	$87.52	$87.52	$89.18
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $229.42 / $229.42 / $309.52	Professional	TC	$229.42	$229.42	$309.52