Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.32 / $21.31 / $39.02	Facility	26	$18.32	$21.31	$39.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $59.04 / $162.97	Professional		$28.64	$59.04	$162.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.18 / $30.67 / $104.18	Professional	26	$18.18	$30.67	$104.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.26 / $236.48 / $388.05	Professional	50	$115.26	$236.48	$388.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $28.58 / $69.23	Professional	TC	$9.18	$28.58	$69.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.23 / $61.41 / $97.33	Professional		$47.23	$61.41	$97.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $31.05 / $61.34	Professional	26	$24.42	$31.05	$61.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.36 / $23.23 / $45.53	Professional	TC	$14.36	$23.23	$45.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $57.32 / $72.34	Professional		$57.32	$57.32	$72.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.23 / $45.06 / $66.95	Professional	26	$30.23	$45.06	$66.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $21.68 / $87.74	Professional	TC	$15.00	$21.68	$87.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.13 / $60.20 / $114.00	Professional		$35.13	$60.20	$114.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $34.25 / $65.34	Professional	26	$23.32	$34.25	$65.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.45 / $22.06 / $65.56	Professional	TC	$11.45	$22.06	$65.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.25 / $29.25 / $64.79	Facility	26	$29.25	$29.25	$64.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $43.77 / $201.44	Professional		$14.00	$43.77	$201.44
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.25 / $29.25 / $29.25	Professional	26	$29.25	$29.25	$29.25
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $65.66 / $65.66 / $302.16	Professional	50	$65.66	$65.66	$302.16
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $116.88 / $116.88 / $116.88	Professional	TC	$116.88	$116.88	$116.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.82 / $48.66 / $100.04	Professional		$24.82	$48.66	$100.04
United Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $58.10 / $115.69	Professional		$31.68	$58.10	$115.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $29.13 / $63.77	Professional	26	$20.43	$29.13	$63.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.25 / $26.63 / $62.01	Professional	TC	$10.25	$26.63	$62.01
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $77.38 / $160.55 / $160.55	Facility	26	$77.38	$160.55	$160.55
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $359.16 / $534.98 / $534.98	Professional		$359.16	$534.98	$534.98
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $193.46 / $265.05 / $265.05	Professional	26	$193.46	$265.05	$265.05
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $214.27 / $269.93 / $269.93	Professional	TC	$214.27	$269.93	$269.93