Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.32 / $17.29 / $29.93	Facility	26	$16.32	$17.29	$29.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.44 / $100.16 / $212.68	Professional		$84.44	$100.16	$212.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $17.67 / $51.76	Professional	26	$16.32	$17.67	$51.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.56 / $81.95 / $141.21	Professional	TC	$69.56	$81.95	$141.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $89.92 / $131.47	Professional		$72.06	$89.92	$131.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $26.72 / $37.69	Professional	26	$14.60	$26.72	$37.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.18 / $44.18 / $44.18	Professional		$44.18	$44.18	$44.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.68 / $39.97 / $49.76	Professional	26	$28.68	$39.97	$49.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.89 / $170.13 / $223.72	Professional	TC	$102.89	$170.13	$223.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.82 / $142.43 / $244.75	Professional		$83.82	$142.43	$244.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.55 / $29.14 / $49.67	Professional	26	$18.55	$29.14	$49.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.37 / $110.53 / $195.59	Professional	TC	$64.37	$110.53	$195.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $24.35 / $29.65 / $50.40	Facility	26	$24.35	$29.65	$50.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $81.00 / $125.00	Professional		$24.00	$81.00	$125.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $27.69 / $27.69 / $27.69	Professional	26	$27.69	$27.69	$27.69
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $99.10 / $300.02 / $300.02	Professional	TC	$99.10	$300.02	$300.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $105.60 / $161.40	Professional		$24.98	$105.60	$161.40
United Facility/Professional Professional Modifier Low / Median / High Price $80.52 / $115.50 / $201.51	Professional		$80.52	$115.50	$201.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $23.12 / $43.62	Professional	26	$18.14	$23.12	$43.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.94 / $91.26 / $160.84	Professional	TC	$62.94	$91.26	$160.84
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $87.12 / $87.12	Facility	26	$42.12	$87.12	$87.12
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $664.33 / $819.75 / $819.75	Professional		$664.33	$819.75	$819.75
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $113.72 / $148.19 / $148.19	Professional	26	$113.72	$148.19	$148.19
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $550.61 / $671.63 / $671.63	Professional	TC	$550.61	$671.63	$671.63