Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $13.49 / $33.11	Facility	26	$9.77	$13.49	$33.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $100.00 / $691.83	Facility	TC	$30.90	$100.00	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $57.54 / $173.78	Professional		$22.91	$57.54	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $22.91 / $61.66	Professional	26	$10.00	$22.91	$61.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $97.72 / $295.12	Professional	50	$42.66	$97.72	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $52.48 / $123.03	Professional	TC	$28.84	$52.48	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $77.62	Professional		$31.62	$44.67	$77.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $21.88	Professional	26	$8.32	$11.48	$21.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $74.13 / $123.03	Professional	50	$52.48	$74.13	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $63.10	Professional	TC	$25.70	$39.81	$63.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $25.12 / $31.62	Professional	26	$15.49	$25.12	$31.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $53.70 / $81.28	Professional	TC	$36.31	$53.70	$81.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $17.78	Facility	26	$2.69	$12.59	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	TC	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $112.20	Professional		$38.02	$61.66	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $29.51	Professional	26	$9.55	$16.22	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $44.67 / $81.28	Professional	TC	$26.30	$44.67	$81.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.05 / $19.05	Professional	26	$19.05	$19.05	$19.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $46.77 / $97.72	Professional		$11.48	$46.77	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $50.12 / $91.20	Professional		$36.31	$50.12	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.49 / $24.55	Professional	26	$10.47	$13.49	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $67.61	Professional	TC	$25.70	$36.31	$67.61
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	TC	$229.09	$229.09	$229.09
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $398.11	Professional		$295.12	$295.12	$398.11
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $89.13	Professional	26	$87.10	$87.10	$89.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $309.03	Professional	TC	$229.09	$229.09	$309.03