Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $18.62 / $33.88	Facility	26	$17.78	$18.62	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $87.10 / $223.87	Professional		$47.86	$87.10	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $29.51 / $77.62	Professional	26	$16.60	$29.51	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $43.65 / $107.15	Professional	TC	$32.36	$43.65	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $97.72	Professional		$38.02	$51.29	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $18.62 / $36.31	Professional	26	$13.49	$18.62	$36.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $45.71	Professional	TC	$45.71	$45.71	$45.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $42.66 / $60.26	Professional	26	$25.70	$42.66	$60.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $85.11 / $141.25	Professional	TC	$46.77	$85.11	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.27 / $19.95 / $28.18	Facility	26	$4.27	$19.95	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $154.88	Professional		$57.54	$97.72	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $27.54 / $47.86	Professional	26	$19.50	$27.54	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $66.07 / $112.20	Professional	TC	$37.15	$66.07	$112.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $123.03	Professional		$100.00	$120.23	$123.03
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $29.51 / $33.11	Professional	26	$28.18	$29.51	$33.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $95.50 / $204.17	Professional		$29.51	$95.50	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $128.82	Professional		$50.12	$75.86	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $22.39 / $38.90	Professional	26	$17.38	$22.39	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $91.20	Professional	TC	$32.36	$50.12	$91.20
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $630.96 / $630.96	Professional		$436.52	$630.96	$630.96
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $457.09 / $457.09	Professional	26	$245.47	$457.09	$457.09
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	TC	$398.11	$398.11	$398.11