Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.10 / $27.70 / $40.47	Facility	26	$24.10	$27.70	$40.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.47 / $168.24 / $333.65	Professional		$146.47	$168.24	$333.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.08 / $24.10 / $52.06	Professional	26	$22.08	$24.10	$52.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.94 / $138.59 / $278.52	Professional	TC	$128.94	$138.59	$278.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.79 / $212.79 / $212.79	Professional		$212.79	$212.79	$212.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $33.36 / $42.53	Professional	26	$17.14	$33.36	$42.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.90 / $64.90 / $64.90	Professional		$64.90	$64.90	$64.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.74 / $46.40 / $80.20	Professional	26	$21.74	$46.40	$80.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.65 / $379.11 / $466.40	Professional	TC	$121.65	$379.11	$466.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.06 / $270.91 / $420.21	Professional		$172.06	$270.91	$420.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $36.67 / $59.30	Professional	26	$24.02	$36.67	$59.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.36 / $234.49 / $357.77	Professional	TC	$145.36	$234.49	$357.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $43.00 / $53.64	Facility	26	$26.65	$43.00	$53.64
Medcost Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $205.00 / $563.22	Professional		$31.00	$205.00	$563.22
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $26.65 / $26.65 / $43.00	Professional	26	$26.65	$26.65	$43.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $337.22 / $381.00 / $844.84	Professional	50	$337.22	$381.00	$844.84
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $474.54 / $474.54 / $474.54	Professional	TC	$474.54	$474.54	$474.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.75 / $213.20 / $345.90	Professional		$35.75	$213.20	$345.90
United Facility/Professional Professional Modifier Low / Median / High Price $156.05 / $232.30 / $417.45	Professional		$156.05	$232.30	$417.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $31.57 / $61.69	Professional	26	$23.46	$31.57	$61.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.57 / $200.23 / $353.56	Professional	TC	$131.57	$200.23	$353.56
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $236.27 / $236.27	Facility	26	$100.00	$236.27	$236.27
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,346.55 / $1,346.55 / $1,470.69	Professional		$1,346.55	$1,346.55	$1,470.69
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $293.89 / $293.89 / $293.89	Professional	26	$293.89	$293.89	$293.89
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,154.84 / $1,154.84 / $1,323.51	Professional	TC	$1,154.84	$1,154.84	$1,323.51