Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.76 / $25.78 / $42.62	Facility	26	$21.76	$25.78	$42.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $88.48 / $253.23	Professional		$81.68	$88.48	$253.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $27.77 / $83.80	Professional	26	$19.89	$27.77	$83.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.91 / $62.40 / $147.22	Professional	TC	$57.91	$62.40	$147.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $71.53 / $93.53	Professional		$71.53	$71.53	$93.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $26.70 / $43.96	Professional	26	$21.17	$26.70	$43.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.12 / $57.12 / $57.12	Professional		$57.12	$57.12	$57.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.84 / $50.75 / $65.31	Professional	26	$35.84	$50.75	$65.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.09 / $115.67 / $176.93	Professional	TC	$74.09	$115.67	$176.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.41 / $131.25 / $237.74	Professional		$74.41	$131.25	$237.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $39.97 / $70.12	Professional	26	$23.44	$39.97	$70.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.53 / $94.66 / $167.95	Professional	TC	$50.53	$94.66	$167.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $33.40 / $38.00 / $68.45	Facility	26	$33.40	$38.00	$68.45
Medcost Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $81.00 / $118.35	Professional		$29.00	$81.00	$118.35
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $33.40 / $38.00	Professional	26	$33.40	$33.40	$38.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $255.13 / $255.13 / $255.13	Professional	TC	$255.13	$255.13	$255.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $106.80 / $174.30	Professional		$42.22	$106.80	$174.30
United Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $118.73 / $220.21	Professional		$79.52	$118.73	$220.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.92 / $38.01 / $69.43	Professional	26	$22.92	$38.01	$69.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $78.87 / $168.15	Professional	TC	$53.70	$78.87	$168.15
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $67.28 / $139.60 / $139.60	Facility	26	$67.28	$139.60	$139.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $648.50 / $648.50 / $804.75	Professional		$648.50	$648.50	$804.75
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $180.32 / $180.32 / $229.28	Professional	26	$180.32	$180.32	$229.28
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $468.12 / $468.12 / $575.40	Professional	TC	$468.12	$468.12	$575.40