Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.62 / $16.82	Facility	26	$10.01	$10.62	$16.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.21 / $228.03 / $403.82	Facility	TC	$22.21	$228.03	$403.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $37.29 / $144.00	Professional		$30.25	$37.29	$144.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $11.79 / $47.20	Professional	26	$9.88	$11.79	$47.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $24.00 / $64.17	Professional	TC	$19.89	$24.00	$64.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $67.26 / $90.04	Professional		$27.63	$67.26	$90.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $14.68 / $28.08	Professional	26	$8.22	$14.68	$28.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.25 / $27.58 / $31.07	Professional	TC	$14.25	$27.58	$31.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $25.89 / $32.77	Professional	26	$18.60	$25.89	$32.77
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.59 / $42.30 / $58.87	Professional	TC	$33.59	$42.30	$58.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $53.93 / $91.73	Professional		$32.70	$53.93	$91.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $18.14 / $31.66	Professional	26	$12.00	$18.14	$31.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $36.44 / $61.10	Professional	TC	$21.10	$36.44	$61.10
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.94 / $19.55 / $34.19	Facility	26	$12.94	$19.55	$34.19
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $29.85 / $30.54 / $50.32	Facility	TC	$29.85	$30.54	$50.32
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $47.55 / $131.82	Professional		$14.00	$47.55	$131.82
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $40.96 / $40.96	Professional	26	$40.96	$40.96	$40.96
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $30.54 / $30.54 / $30.54	Professional	TC	$30.54	$30.54	$30.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $34.01 / $60.71	Professional		$11.12	$34.01	$60.71
United Facility/Professional Professional Modifier Low / Median / High Price $31.81 / $44.56 / $83.41	Professional		$31.81	$44.56	$83.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $15.25 / $28.80	Professional	26	$11.32	$15.25	$28.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.16 / $30.45 / $53.18	Professional	TC	$21.16	$30.45	$53.18
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $26.10 / $70.00 / $70.00	Facility	26	$26.10	$70.00	$70.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $50.86 / $142.31 / $142.31	Facility	TC	$50.86	$142.31	$142.31
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $236.84 / $310.73 / $310.73	Professional		$236.84	$310.73	$310.73
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $70.37 / $88.88 / $88.88	Professional	26	$70.37	$88.88	$88.88
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $166.53 / $221.85 / $221.85	Professional	TC	$166.53	$221.85	$221.85