Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.28 / $84.63 / $96.30	Facility		$22.28	$84.63	$96.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.76 / $27.38 / $32.75	Facility	26	$22.76	$27.38	$32.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.96 / $41.80 / $60.72	Facility	TC	$27.96	$41.80	$60.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $102.31 / $234.73	Professional		$75.00	$102.31	$234.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.05 / $36.20 / $123.34	Professional	26	$27.05	$36.20	$123.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.32 / $65.84 / $148.34	Professional	TC	$50.32	$65.84	$148.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $86.19 / $202.05	Professional		$48.75	$86.19	$202.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $39.79 / $97.46	Professional	26	$15.92	$39.79	$97.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.06 / $74.06 / $88.00	Professional	TC	$74.06	$74.06	$88.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.29 / $127.91 / $161.60	Professional		$77.29	$127.91	$161.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.66 / $65.67 / $86.04	Professional	26	$28.66	$65.67	$86.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.34 / $62.05 / $112.88	Professional	TC	$48.34	$62.05	$112.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $74.98 / $178.87	Professional		$42.95	$74.98	$178.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $30.73 / $72.58	Professional	26	$16.91	$30.73	$72.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $34.47 / $104.52	Professional	TC	$22.13	$34.47	$104.52
Medcost Facility/Professional Facility Modifier Low / Median / High Price $85.02 / $100.56 / $179.34	Facility		$85.02	$100.56	$179.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $56.00 / $56.00 / $96.05	Facility	26	$56.00	$56.00	$96.05
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $67.20 / $86.85 / $150.79	Facility	TC	$67.20	$86.85	$150.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $45.90 / $45.90	Professional		$45.90	$45.90	$45.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.35 / $67.70 / $203.70	Professional		$21.35	$67.70	$203.70
United Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $83.51 / $171.50	Professional		$57.13	$83.51	$171.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $31.12 / $70.38	Professional	26	$21.57	$31.12	$70.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.92 / $53.50 / $112.60	Professional	TC	$35.92	$53.50	$112.60
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $600.35 / $600.35 / $600.35	Facility		$600.35	$600.35	$600.35
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $170.73 / $170.73 / $170.73	Facility	26	$170.73	$170.73	$170.73
Wellcare Facility/Professional Facility Modifier TC Low / Median / High Price $432.16 / $432.16 / $432.16	Facility	TC	$432.16	$432.16	$432.16
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $661.34 / $661.34 / $938.48	Professional		$661.34	$661.34	$938.48
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $269.70 / $278.39 / $278.39	Professional	26	$269.70	$278.39	$278.39
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $424.71 / $424.71 / $668.78	Professional	TC	$424.71	$424.71	$668.78