Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.72 / $23.54 / $39.54	Facility	26	$16.72	$23.54	$39.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.24 / $122.72 / $282.05	Professional		$99.24	$122.72	$282.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $23.54 / $67.16	Professional	26	$14.49	$23.54	$67.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.54 / $104.37 / $200.95	Professional	TC	$97.54	$104.37	$200.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.61 / $155.61 / $155.61	Professional		$155.61	$155.61	$155.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $30.86 / $47.77	Professional	26	$17.09	$30.86	$47.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $39.65 / $39.65	Professional		$39.65	$39.65	$39.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.51 / $33.51 / $66.55	Professional	26	$22.51	$33.51	$66.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $133.63 / $185.73 / $281.48	Professional	TC	$133.63	$185.73	$281.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $201.94 / $317.11	Professional		$134.97	$201.94	$317.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $28.68 / $54.03	Professional	26	$17.57	$28.68	$54.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.18 / $173.62 / $258.85	Professional	TC	$109.18	$173.62	$258.85
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.39 / $26.00 / $50.95	Facility	26	$16.39	$26.00	$50.95
Medcost Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $130.00 / $445.61	Professional		$31.00	$130.00	$445.61
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $16.39 / $26.00	Professional	26	$16.39	$16.39	$26.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $358.98 / $358.98 / $358.98	Professional	TC	$358.98	$358.98	$358.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $124.39 / $222.34	Professional		$24.24	$124.39	$222.34
United Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $174.85 / $337.82	Professional		$123.00	$174.85	$337.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.73 / $25.70 / $55.01	Professional	26	$14.73	$25.70	$55.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.55 / $149.00 / $269.30	Professional	TC	$98.55	$149.00	$269.30
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $53.56 / $109.96 / $109.96	Facility	26	$53.56	$109.96	$109.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,030.20 / $1,030.20 / $1,049.58	Professional		$1,030.20	$1,030.20	$1,049.58
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $203.09 / $203.09 / $203.09	Professional	26	$203.09	$203.09	$203.09
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $845.33 / $845.33 / $960.39	Professional	TC	$845.33	$845.33	$960.39