Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.26 / $34.25 / $56.81	Facility	26	$31.26	$34.25	$56.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.61 / $104.98 / $245.60	Professional		$87.61	$104.98	$245.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $33.11 / $87.44	Professional	26	$30.06	$33.11	$87.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.08 / $232.10 / $749.61	Professional	50	$141.08	$232.10	$749.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.79 / $68.13 / $140.85	Professional	TC	$59.79	$68.13	$140.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $76.25 / $209.21	Professional		$74.38	$76.25	$209.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $38.75 / $46.19	Professional	26	$26.46	$38.75	$46.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $110.87 / $114.37 / $313.81	Professional	50	$110.87	$114.37	$313.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.36 / $51.36 / $74.09	Professional	TC	$51.36	$51.36	$74.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.94 / $73.41 / $105.96	Professional	26	$49.94	$73.41	$105.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.14 / $136.91 / $200.88	Professional	TC	$93.14	$136.91	$200.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.72 / $39.72 / $39.72	Facility	26	$39.72	$39.72	$39.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.48 / $155.15 / $265.62	Professional		$106.48	$155.15	$265.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.03 / $54.72 / $93.82	Professional	26	$37.03	$54.72	$93.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.64 / $101.68 / $174.19	Professional	TC	$68.64	$101.68	$174.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.68 / $54.68 / $96.38	Facility	26	$54.68	$54.68	$96.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $132.00 / $372.38	Professional		$46.00	$132.00	$372.38
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $54.68 / $54.68 / $127.88	Professional	26	$54.68	$54.68	$127.88
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $232.26 / $232.26 / $558.57	Professional	50	$232.26	$232.26	$558.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $74.38 / $155.54	Professional		$33.72	$74.38	$155.54
United Facility/Professional Professional Modifier Low / Median / High Price $98.15 / $135.34 / $271.48	Professional		$98.15	$135.34	$271.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $47.28 / $95.82	Professional	26	$35.79	$47.28	$95.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.50 / $86.26 / $167.72	Professional	TC	$66.50	$86.26	$167.72
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $82.13 / $170.67 / $170.67	Facility	26	$82.13	$170.67	$170.67
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $667.61 / $853.65 / $853.65	Professional		$667.61	$853.65	$853.65
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $219.03 / $281.02 / $281.02	Professional	26	$219.03	$281.02	$281.02
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $448.58 / $572.54 / $572.54	Professional	TC	$448.58	$572.54	$572.54