Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.77 / $8.94 / $13.05	Facility	26	$8.77	$8.94	$13.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.61 / $56.16 / $131.90	Professional		$50.61	$56.16	$131.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $8.94 / $30.80	Professional	26	$7.83	$8.94	$30.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.97 / $27.98 / $32.24	Professional	52	$25.97	$27.98	$32.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $47.17 / $83.81	Professional	TC	$43.71	$47.17	$83.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.84 / $73.89 / $93.47	Professional		$47.84	$73.89	$93.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.48 / $15.94	Professional	26	$8.27	$12.48	$15.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.28 / $60.85 / $77.56	Professional	TC	$55.28	$60.85	$77.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $70.00 / $80.00	Professional		$19.80	$70.00	$80.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.16 / $15.45 / $24.40	Professional	26	$8.16	$15.45	$24.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.45 / $80.92 / $129.05	Professional	TC	$42.45	$80.92	$129.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $81.56 / $136.26	Professional		$57.90	$81.56	$136.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $12.97 / $22.77	Professional	26	$9.47	$12.97	$22.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.17 / $68.61 / $114.48	Professional	TC	$48.17	$68.61	$114.48
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.19 / $15.49 / $23.39	Facility	26	$10.19	$15.49	$23.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $59.76 / $75.00	Professional		$12.00	$59.76	$75.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $50.27 / $50.27 / $50.27	Professional	TC	$50.27	$50.27	$50.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.10 / $62.50 / $100.21	Professional		$11.10	$62.50	$100.21
United Facility/Professional Professional Modifier Low / Median / High Price $47.05 / $63.17 / $124.95	Professional		$47.05	$63.17	$124.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.77 / $10.01 / $17.85	Professional	26	$7.77	$10.01	$17.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $51.82 / $91.57	Professional	TC	$39.22	$51.82	$91.57
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $80.00 / $85.00	Facility	26	$20.60	$80.00	$85.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $373.69 / $373.69 / $472.95	Professional		$373.69	$373.69	$472.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $55.28 / $70.05	Professional	26	$55.28	$55.28	$70.05
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $318.41 / $318.41 / $402.90	Professional	TC	$318.41	$318.41	$402.90