Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.60 / $65.59 / $71.00	Facility		$43.60	$65.59	$71.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.72 / $9.23 / $9.43	Facility	26	$7.72	$9.23	$9.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.03 / $35.88 / $54.28	Facility	TC	$29.03	$35.88	$54.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.16 / $84.97 / $246.94	Professional		$54.16	$84.97	$246.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $18.11 / $78.34	Professional	26	$9.44	$18.11	$78.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.06 / $68.56 / $132.57	Professional	TC	$46.06	$68.56	$132.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $78.31 / $147.49	Professional		$45.79	$78.31	$147.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $12.25 / $24.68	Professional	26	$11.81	$12.25	$24.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.20 / $66.20 / $126.42	Professional	TC	$66.20	$66.20	$126.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $84.50 / $95.17	Professional		$57.38	$84.50	$95.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $20.30 / $26.23	Professional	26	$9.86	$20.30	$26.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $56.19 / $90.62	Professional	TC	$17.28	$56.19	$90.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.58 / $44.01 / $121.39	Professional		$26.58	$44.01	$121.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.49 / $6.42 / $21.10	Professional	26	$5.49	$6.42	$21.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $32.94 / $101.11	Professional	TC	$20.17	$32.94	$101.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $80.00 / $116.58	Facility		$52.00	$80.00	$116.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.47 / $21.00 / $39.00	Facility	26	$16.47	$21.00	$39.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $56.81 / $83.63 / $132.66	Facility	TC	$56.81	$83.63	$132.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $9.00 / $9.00 / $9.00	Professional		$9.00	$9.00	$9.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.16 / $44.95 / $166.94	Professional		$7.16	$44.95	$166.94
United Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $49.73 / $119.66	Professional		$38.84	$49.73	$119.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $11.85 / $20.99	Professional	26	$6.94	$11.85	$20.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $49.85 / $103.36	Professional	TC	$32.90	$49.85	$103.36
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $444.13 / $444.13 / $444.13	Facility		$444.13	$444.13	$444.13
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 $386.32 / $386.32 / $386.32	Facility	TC	$386.32	$386.32	$386.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $514.55 / $514.55 / $692.33	Professional		$514.55	$514.55	$692.33
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $87.52 / $94.35	Professional	26	$87.52	$87.52	$94.35
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $439.92 / $439.92 / $598.04	Professional	TC	$439.92	$439.92	$598.04