Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $38.90 / $120.23	Facility	26	$30.90	$38.90	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $371.54	Professional		$77.62	$117.49	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $53.70 / $199.53	Professional	26	$30.90	$53.70	$199.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $234.42 / $776.25	Professional	50	$67.61	$234.42	$776.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $72.44 / $165.96	Professional	TC	$56.23	$72.44	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $169.82	Professional		$66.07	$79.43	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $39.81 / $69.18	Professional	26	$26.30	$39.81	$69.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $141.25 / $257.04	Professional	50	$112.20	$141.25	$257.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $144.54	Professional	TC	$48.98	$74.13	$144.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $64.57 / $107.15	Professional	26	$48.98	$64.57	$107.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $120.23 / $199.53	Professional	TC	$93.33	$120.23	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	26	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $263.03	Professional		$91.20	$151.36	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $52.48 / $93.33	Professional	26	$30.90	$52.48	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $100.00 / $173.78	Professional	TC	$60.26	$100.00	$173.78
Medcost Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $95.50 / $204.17	Professional		$35.48	$95.50	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $223.87	Professional		$95.50	$125.89	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $77.62	Professional	26	$33.11	$43.65	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $79.43 / $144.54	Professional	TC	$63.10	$79.43	$144.54
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $851.14	Professional		$660.69	$660.69	$851.14
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $218.78 / $281.84	Professional	26	$218.78	$218.78	$281.84
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $446.68 / $575.44	Professional	TC	$446.68	$446.68	$575.44