Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $19.50 / $123.03	Facility		$10.00	$19.50	$123.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $15.49 / $36.31	Facility	26	$6.03	$15.49	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $13.80 / $40.74	Professional		$9.77	$13.80	$40.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $30.90	Professional	26	$6.03	$8.91	$30.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $12.30 / $29.51	Professional	50	$11.48	$12.30	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $9.55	Professional	TC	$3.02	$3.98	$9.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $9.55 / $15.49	Professional		$8.51	$9.55	$15.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $10.23	Professional	26	$10.23	$10.23	$10.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.02 / $3.02	Professional	TC	$3.02	$3.02	$3.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $23.44	Professional		$23.44	$23.44	$23.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $14.45 / $25.70	Professional	26	$7.41	$14.45	$25.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.24 / $3.89 / $10.96	Professional	TC	$3.24	$3.89	$10.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5.50 / $10.23 / $25.12	Facility		$5.50	$10.23	$25.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.30	Facility	26	$1.86	$8.71	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $17.38 / $32.36	Professional		$11.75	$17.38	$32.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.59 / $21.88	Professional	26	$7.76	$12.59	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.75 / $5.25 / $10.00	Professional	TC	$2.75	$5.25	$10.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $19.95 / $24.55	Professional		$17.38	$19.95	$24.55
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.60 / $16.98	Professional	26	$13.49	$16.60	$16.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $16.22 / $28.18	Facility		$10.00	$16.22	$28.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $11.22	Professional		$11.22	$11.22	$11.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $26.92 / $60.26	Professional		$15.14	$26.92	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $3.02 / $14.45 / $20.89	Facility		$3.02	$14.45	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $14.45 / $28.18	Professional		$10.72	$14.45	$28.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.23 / $19.05	Professional	26	$7.59	$10.23	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $4.47 / $9.33	Professional	TC	$2.88	$4.47	$9.33
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
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 Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional	26	$1,288.25	$1,288.25	$1,288.25
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $977.24 / $977.24	Professional	TC	$977.24	$977.24	$977.24