Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.36 / $20.26	Facility	26	$12.02	$12.36	$20.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.04 / $88.32 / $230.33	Professional		$60.04	$88.32	$230.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $12.47 / $35.27	Professional	26	$10.83	$12.47	$35.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.86 / $39.56 / $143.50	Professional	52	$37.86	$39.56	$143.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.70 / $80.63 / $142.21	Professional	TC	$64.70	$80.63	$142.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.85 / $110.47 / $147.12	Professional		$58.85	$110.47	$147.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.76 / $15.81 / $21.80	Professional	26	$8.76	$15.81	$21.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $119.03 / $119.03	Professional	TC	$42.66	$119.03	$119.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $32.29 / $32.29	Professional		$32.29	$32.29	$32.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $23.28 / $41.09	Professional	26	$10.83	$23.28	$41.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.73 / $114.83 / $242.22	Professional	TC	$62.73	$114.83	$242.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $144.32 / $217.37	Professional		$87.73	$144.32	$217.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $18.05 / $29.78	Professional	26	$12.11	$18.05	$29.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.98 / $123.46 / $186.15	Professional	TC	$74.98	$123.46	$186.15
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.84 / $22.00 / $28.68	Facility	26	$12.84	$22.00	$28.68
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $105.00 / $291.12	Professional		$16.00	$105.00	$291.12
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $12.84 / $22.00	Professional	26	$12.84	$12.84	$22.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $246.85 / $246.85 / $246.85	Professional	TC	$246.85	$246.85	$246.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.82 / $86.50 / $140.81	Professional		$14.82	$86.50	$140.81
United Facility/Professional Professional Modifier Low / Median / High Price $80.93 / $124.03 / $211.77	Professional		$80.93	$124.03	$211.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $15.54 / $30.18	Professional	26	$11.30	$15.54	$30.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.40 / $103.00 / $181.59	Professional	TC	$68.40	$103.00	$181.59
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $97.26 / $125.86 / $125.86	Facility	26	$97.26	$125.86	$125.86
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $692.85 / $692.85 / $789.60	Professional		$692.85	$692.85	$789.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $267.48 / $267.48 / $267.48	Professional	26	$267.48	$267.48	$267.48
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $596.40 / $596.40 / $717.62	Professional	TC	$596.40	$596.40	$717.62