Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.49 / $34.47 / $286.58	Facility	26	$32.49	$34.47	$286.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.23 / $148.90 / $496.00	Professional		$112.23	$148.90	$496.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.49 / $37.63 / $105.42	Professional	26	$32.49	$37.63	$105.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $55.63 / $726.00	Professional	52	$17.78	$55.63	$726.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.73 / $92.97 / $244.84	Professional	TC	$79.73	$92.97	$244.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.37 / $239.96 / $371.38	Professional		$93.37	$239.96	$371.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $56.64 / $76.12	Professional	26	$27.06	$56.64	$76.12
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $22.65 / $29.18 / $65.66	Professional	52	$22.65	$29.18	$65.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.31 / $114.48 / $126.24	Professional	TC	$66.31	$114.48	$126.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $214.76	Professional		$200.00	$200.00	$214.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.20 / $83.74 / $105.21	Professional	26	$59.20	$83.74	$105.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.57 / $186.96 / $271.31	Professional	TC	$149.57	$186.96	$271.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	26	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.31 / $207.96 / $350.04	Professional		$134.31	$207.96	$350.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.14 / $57.74 / $100.87	Professional	26	$38.14	$57.74	$100.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.69 / $149.29 / $252.83	Professional	TC	$95.69	$149.29	$252.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $42.31 / $55.02 / $101.59	Facility	26	$42.31	$55.02	$101.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $166.00 / $458.90	Professional		$47.00	$166.00	$458.90
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $55.02 / $55.02 / $55.02	Professional	26	$55.02	$55.02	$55.02
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $140.22 / $326.05 / $326.05	Professional	TC	$140.22	$326.05	$326.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.02 / $118.97 / $210.17	Professional		$37.02	$118.97	$210.17
United Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $205.53 / $347.32	Professional		$130.16	$205.53	$347.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.64 / $56.99 / $96.19	Professional	26	$36.64	$56.99	$96.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.91 / $147.57 / $246.51	Professional	TC	$92.91	$147.57	$246.51
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $85.37 / $177.27 / $177.27	Facility	26	$85.37	$177.27	$177.27
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $825.92 / $1,076.40 / $1,076.40	Professional		$825.92	$1,076.40	$1,076.40
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $227.63 / $291.60 / $291.60	Professional	26	$227.63	$291.60	$291.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $598.35 / $784.73 / $784.73	Professional	TC	$598.35	$784.73	$784.73