Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.07 / $13.07 / $24.48	Facility	26	$13.07	$13.07	$24.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.25 / $50.21 / $137.16	Professional		$44.25	$50.21	$137.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $13.07 / $29.87	Professional	26	$12.37	$13.07	$29.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.18 / $35.08 / $70.56	Professional	TC	$31.18	$35.08	$70.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $40.03 / $40.03	Professional		$40.03	$40.03	$40.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.80 / $21.80 / $21.80	Professional	26	$21.80	$21.80	$21.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.62 / $28.62 / $28.62	Professional	TC	$28.62	$28.62	$28.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.78 / $30.89 / $42.93	Professional	26	$23.78	$30.89	$42.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.76 / $78.68 / $109.34	Professional	TC	$62.76	$78.68	$109.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.74 / $83.81 / $141.62	Professional		$53.74	$83.81	$141.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.57 / $23.70 / $40.61	Professional	26	$15.57	$23.70	$40.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.17 / $60.11 / $100.75	Professional	TC	$38.17	$60.11	$100.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.03 / $22.48 / $40.54	Facility	26	$17.03	$22.48	$40.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $50.00 / $75.00	Professional		$20.00	$50.00	$75.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $22.48 / $22.48 / $22.48	Professional	26	$22.48	$22.48	$22.48
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $57.27 / $57.27 / $127.51	Professional	TC	$57.27	$57.27	$127.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $49.95 / $89.16	Professional		$15.05	$49.95	$89.16
United Facility/Professional Professional Modifier Low / Median / High Price $50.98 / $67.81 / $133.30	Professional		$50.98	$67.81	$133.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.57 / $19.07 / $37.89	Professional	26	$14.57	$19.07	$37.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.21 / $48.31 / $99.52	Professional	TC	$36.21	$48.31	$99.52
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $325.58 / $454.50 / $454.50	Professional		$325.58	$454.50	$454.50
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $91.83 / $112.65 / $112.65	Professional	26	$91.83	$112.65	$112.65
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $233.75 / $341.85 / $341.85	Professional	TC	$233.75	$341.85	$341.85