Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.89 / $28.25 / $43.01	Facility	26	$24.89	$28.25	$43.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $79.34 / $204.79	Professional		$51.44	$79.34	$204.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $27.36 / $97.65	Professional	26	$23.46	$27.36	$97.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.72 / $28.62 / $228.44	Professional	52	$25.72	$28.62	$228.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $55.88 / $77.31	Professional	TC	$26.56	$55.88	$77.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $43.79 / $57.16	Professional		$43.79	$43.79	$57.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.78 / $39.35 / $57.20	Professional	26	$5.78	$39.35	$57.20
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.95 / $14.36 / $255.72	Professional	52	$10.95	$14.36	$255.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $22.74 / $77.06	Professional	TC	$22.22	$22.74	$77.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.12 / $68.12 / $68.12	Professional		$68.12	$68.12	$68.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $58.01 / $78.48	Professional	26	$38.15	$58.01	$78.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.03 / $109.92 / $165.43	Professional	TC	$64.03	$109.92	$165.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $111.79 / $208.19	Professional		$70.59	$111.79	$208.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $41.28 / $70.79	Professional	26	$25.11	$41.28	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.38 / $68.95 / $142.32	Professional	TC	$39.38	$68.95	$142.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $46.00 / $66.18	Facility	26	$39.14	$46.00	$66.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $111.00 / $210.35	Professional		$34.00	$111.00	$210.35
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $39.14 / $46.00	Professional	26	$39.14	$39.14	$46.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $108.60 / $108.60 / $108.60	Professional	TC	$108.60	$108.60	$108.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $52.87 / $113.58	Professional		$27.59	$52.87	$113.58
United Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $97.69 / $169.68	Professional		$70.80	$97.69	$169.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.15 / $34.52 / $68.38	Professional	26	$25.15	$34.52	$68.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.06 / $62.95 / $112.14	Professional	TC	$47.06	$62.95	$112.14
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $73.63 / $132.47 / $132.47	Facility	26	$73.63	$132.47	$132.47
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $456.91 / $456.91 / $482.48	Professional		$456.91	$456.91	$482.48
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $265.83 / $265.83 / $265.83	Professional	26	$265.83	$265.83	$265.83
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $406.97 / $406.97 / $406.97	Professional	TC	$406.97	$406.97	$406.97