Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.51 / $37.72 / $96.57	Facility		$15.51	$37.72	$96.57
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.26 / $8.43 / $8.88	Facility	26	$7.26	$8.43	$8.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.07 / $24.40 / $31.23	Facility	TC	$17.07	$24.40	$31.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $47.98 / $110.00	Professional		$31.71	$47.98	$110.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $10.73 / $54.06	Professional	26	$7.63	$10.73	$54.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.36 / $30.12 / $59.46	Professional	TC	$20.36	$30.12	$59.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.36 / $42.20 / $48.38	Professional		$18.36	$42.20	$48.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.16 / $11.53 / $20.16	Professional	26	$5.16	$11.53	$20.16
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.74 / $29.74 / $29.74	Professional	TC	$29.74	$29.74	$29.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $20.58 / $26.88	Professional	26	$9.30	$20.58	$26.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.37 / $32.85 / $63.30	Professional	TC	$28.37	$32.85	$63.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $35.78 / $85.49	Professional		$19.82	$35.78	$85.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.31 / $9.65 / $19.32	Professional	26	$5.31	$9.65	$19.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.23 / $25.15 / $68.33	Professional	TC	$14.23	$25.15	$68.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $39.97 / $70.00 / $110.00	Facility		$39.97	$70.00	$110.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.42 / $46.00 / $72.00	Facility	26	$15.42	$46.00	$72.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $27.60 / $56.21 / $111.60	Facility	TC	$27.60	$56.21	$111.60
Medcost Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $36.00 / $36.00	Professional		$36.00	$36.00	$36.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.71 / $25.09 / $85.24	Professional		$6.71	$25.09	$85.24
United Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $39.36 / $84.98	Professional		$23.62	$39.36	$84.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $10.85 / $20.25	Professional	26	$6.50	$10.85	$20.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $28.35 / $70.31	Professional	TC	$16.67	$28.35	$70.31
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $228.14 / $228.14 / $228.14	Facility		$228.14	$228.14	$228.14
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $173.52 / $173.52 / $173.52	Facility	TC	$173.52	$173.52	$173.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $359.03 / $370.81 / $370.81	Professional		$359.03	$370.81	$370.81
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $191.54 / $191.54 / $191.54	Professional	26	$191.54	$191.54	$191.54
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $271.66 / $275.49 / $275.49	Professional	TC	$271.66	$275.49	$275.49