Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.96 / $8.42 / $12.82	Facility	26	$6.96	$8.42	$12.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.10 / $36.40 / $78.17	Professional		$22.10	$36.40	$78.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $7.94 / $34.54	Professional	26	$6.89	$7.94	$34.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.40 / $120.70 / $158.02	Professional	50	$109.40	$120.70	$158.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.04 / $12.58 / $23.01	Professional	52	$11.04	$12.58	$23.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $22.17 / $74.76	Professional	TC	$18.17	$22.17	$74.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $44.36 / $44.36	Professional		$21.01	$44.36	$44.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.96 / $16.18	Professional	26	$5.75	$7.96	$16.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $21.84 / $32.60	Professional	TC	$21.84	$21.84	$32.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.85 / $19.85 / $19.85	Professional		$19.85	$19.85	$19.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $17.23 / $22.64	Professional	26	$12.08	$17.23	$22.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.88 / $37.50 / $52.07	Professional	TC	$26.88	$37.50	$52.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $42.74 / $71.09	Professional		$25.77	$42.74	$71.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $12.27 / $21.52	Professional	26	$7.20	$12.27	$21.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $30.29 / $49.98	Professional	TC	$17.39	$30.29	$49.98
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.27 / $14.00 / $23.01	Facility	26	$11.27	$14.00	$23.01
Medcost Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $23.00 / $36.00	Professional		$10.00	$23.00	$36.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $14.00 / $28.52	Professional	26	$11.27	$14.00	$28.52
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $54.21 / $63.00 / $154.22	Professional	50	$54.21	$63.00	$154.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.52 / $35.79 / $63.00	Professional		$11.52	$35.79	$63.00
United Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $38.27 / $68.64	Professional		$25.92	$38.27	$68.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $10.74 / $21.58	Professional	26	$7.73	$10.74	$21.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.70 / $25.10 / $49.16	Professional	TC	$17.70	$25.10	$49.16
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $184.96 / $184.96 / $238.88	Professional		$184.96	$184.96	$238.88
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $62.33 / $67.13 / $67.13	Professional	26	$62.33	$67.13	$67.13
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $149.00 / $149.00 / $176.55	Professional	TC	$149.00	$149.00	$176.55