Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.40 / $40.64 / $65.00	Facility	26	$37.40	$40.64	$65.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.28 / $78.80 / $181.77	Professional		$61.28	$78.80	$181.77
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $38.71 / $97.63	Professional	26	$34.02	$38.71	$97.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $42.35 / $82.91	Professional	TC	$22.57	$42.35	$82.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.32 / $113.73 / $150.21	Professional		$95.32	$113.73	$150.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.55 / $59.54 / $66.83	Professional	26	$48.55	$59.54	$66.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.86 / $64.86 / $64.86	Professional	TC	$64.86	$64.86	$64.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $80.00 / $80.00	Professional		$80.00	$80.00	$80.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $64.20 / $123.69	Professional	26	$34.02	$64.20	$123.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.06 / $47.51 / $62.87	Professional	TC	$37.06	$47.51	$62.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $102.15 / $184.07	Professional		$72.40	$102.15	$184.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.25 / $63.40 / $101.95	Professional	26	$42.25	$63.40	$101.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $42.12 / $80.16	Professional	TC	$24.84	$42.12	$80.16
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $43.40 / $44.17 / $66.22	Facility	26	$43.40	$44.17	$66.22
Medcost Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $52.61 / $81.00	Professional		$29.00	$52.61	$81.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $44.17 / $44.17	Professional	26	$44.17	$44.17	$44.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.94 / $64.06 / $123.84	Professional		$55.94	$64.06	$123.84
United Facility/Professional Professional Modifier Low / Median / High Price $56.31 / $78.73 / $143.43	Professional		$56.31	$78.73	$143.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $46.33 / $80.69	Professional	26	$34.15	$46.33	$80.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $31.15 / $60.61	Professional	TC	$18.85	$31.15	$60.61
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $85.71 / $178.60	Facility	26	$80.00	$85.71	$178.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $568.04 / $568.04 / $640.95	Professional		$568.04	$568.04	$640.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $236.22 / $236.22 / $288.98	Professional	26	$236.22	$236.22	$288.98
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $285.88 / $285.88 / $351.98	Professional	TC	$285.88	$285.88	$351.98