Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.40 / $15.13 / $25.63	Facility	26	$13.40	$15.13	$25.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $41.83 / $87.59	Professional		$34.77	$41.83	$87.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.13 / $14.39 / $41.43	Professional	26	$13.13	$14.39	$41.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.35 / $26.00 / $55.60	Professional	TC	$21.35	$26.00	$55.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $15.20 / $31.68	Professional	26	$6.90	$15.20	$31.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.58 / $40.58 / $40.58	Professional		$40.58	$40.58	$40.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $33.64 / $45.25	Professional	26	$24.77	$33.64	$45.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.37 / $72.50 / $133.66	Professional	TC	$51.37	$72.50	$133.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $75.83 / $134.77	Professional		$42.38	$75.83	$134.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $24.54 / $43.24	Professional	26	$14.75	$24.54	$43.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.46 / $50.23 / $106.58	Professional	TC	$25.46	$50.23	$106.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.19 / $27.00 / $42.32	Facility	26	$23.19	$27.00	$42.32
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $27.00 / $53.00	Professional		$20.00	$27.00	$53.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $23.19 / $23.19 / $27.00	Professional	26	$23.19	$23.19	$27.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $90.86 / $90.86 / $90.86	Professional	TC	$90.86	$90.86	$90.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.39 / $39.67 / $76.09	Professional		$15.39	$39.67	$76.09
United Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $64.48 / $104.52	Professional		$38.61	$64.48	$104.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.43 / $22.22 / $39.52	Professional	26	$15.43	$22.22	$39.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.76 / $41.82 / $66.11	Professional	TC	$22.76	$41.82	$66.11
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $100.00 / $100.00	Facility	26	$49.08	$100.00	$100.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $346.50 / $390.88 / $390.88	Professional		$346.50	$390.88	$390.88
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $103.00 / $103.00 / $121.80	Professional	26	$103.00	$103.00	$121.80
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $258.12 / $301.75 / $301.75	Professional	TC	$258.12	$301.75	$301.75