Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $30.20 / $85.11	Facility	26	$25.12	$30.20	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $323.59	Professional		$51.29	$91.20	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $42.66 / $109.65	Professional	26	$23.44	$42.66	$109.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.77 / $91.20 / $323.59	Professional	52	$46.77	$91.20	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $51.29 / $131.83	Professional	TC	$25.70	$51.29	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $47.86 / $95.50	Professional		$43.65	$47.86	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $28.18 / $51.29	Professional	26	$10.47	$28.18	$51.29
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $15.49 / $15.49 / $15.49	Professional	52	$15.49	$15.49	$15.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.02 / $77.62	Professional	TC	$22.91	$38.02	$77.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $58.88 / $77.62	Professional	26	$35.48	$58.88	$77.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $100.00 / $177.83	Professional	TC	$58.88	$100.00	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $44.67	Facility	26	$6.61	$30.90	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $109.65 / $194.98	Professional		$69.18	$109.65	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $39.81 / $70.79	Professional	26	$23.44	$39.81	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $66.07 / $125.89	Professional	TC	$38.90	$66.07	$125.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $141.25	Professional		$112.20	$125.89	$141.25
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $47.86 / $58.88	Professional	26	$38.90	$47.86	$58.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $58.88 / $154.88	Professional		$29.51	$58.88	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $165.96	Professional		$70.79	$91.20	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $31.62 / $60.26	Professional	26	$24.55	$31.62	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $58.88 / $112.20	Professional	TC	$43.65	$58.88	$112.20
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $478.63	Professional		$457.09	$457.09	$478.63
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	26	$263.03	$263.03	$263.03
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	TC	$407.38	$407.38	$407.38