Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.78 / $14.63 / $22.58	Facility	26	$11.78	$14.63	$22.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $42.61 / $122.48	Professional		$34.94	$42.61	$122.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $13.21 / $37.58	Professional	26	$11.73	$13.21	$37.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.97 / $19.75 / $27.36	Professional	52	$17.97	$19.75	$27.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.71 / $55.94	Professional	TC	$22.26	$27.71	$55.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.43 / $60.43 / $60.43	Professional		$60.43	$60.43	$60.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $25.45 / $25.45	Professional	26	$10.11	$25.45	$25.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $31.20 / $31.20	Professional		$31.20	$31.20	$31.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $30.32 / $39.99	Professional	26	$20.00	$30.32	$39.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.43 / $52.91 / $68.30	Professional	TC	$41.43	$52.91	$68.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $62.76 / $108.62	Professional		$38.54	$62.76	$108.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $21.21 / $37.18	Professional	26	$12.72	$21.21	$37.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.80 / $40.29 / $75.23	Professional	TC	$24.80	$40.29	$75.23
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.20 / $23.11 / $43.20	Facility	26	$15.20	$23.11	$43.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $26.00 / $51.12	Professional		$18.00	$26.00	$51.12
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $48.21 / $48.21 / $48.21	Professional	26	$48.21	$48.21	$48.21
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $30.89 / $30.89 / $44.80	Professional	TC	$30.89	$30.89	$44.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $51.07 / $73.40	Professional		$19.96	$51.07	$73.40
United Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $53.41 / $97.72	Professional		$36.88	$53.41	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $19.09 / $38.67	Professional	26	$13.23	$19.09	$38.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.73 / $36.69 / $72.65	Professional	TC	$23.73	$36.69	$72.65
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $80.00 / $80.00	Facility	26	$36.81	$80.00	$80.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $290.45 / $381.90 / $381.90	Professional		$290.45	$381.90	$381.90
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $82.68 / $106.35 / $106.35	Professional	26	$82.68	$106.35	$106.35
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $207.72 / $275.55 / $275.55	Professional	TC	$207.72	$275.55	$275.55