Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $381.30 / $903.00 / $6,953.60	Facility		$381.30	$903.00	$6,953.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.85 / $172.15 / $202.67	Facility	26	$122.85	$172.15	$202.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.22 / $474.43 / $922.75	Professional		$368.22	$474.43	$922.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.12 / $132.90 / $265.36	Professional	26	$122.12	$132.90	$265.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.11 / $258.45 / $470.69	Professional	TC	$214.11	$258.45	$470.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $475.49 / $475.49 / $641.80	Professional		$475.49	$475.49	$641.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $150.47 / $247.24 / $366.36	Professional	26	$150.47	$247.24	$366.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $258.20 / $370.08 / $589.17	Professional	TC	$258.20	$370.08	$589.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.36 / $571.95 / $988.20	Professional		$380.36	$571.95	$988.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.94 / $214.59 / $371.37	Professional	26	$154.94	$214.59	$371.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.65 / $361.80 / $616.05	Professional	TC	$223.65	$361.80	$616.05
Medcost Facility/Professional Facility Modifier Low / Median / High Price $360.86 / $409.51 / $819.00	Facility		$360.86	$409.51	$819.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $168.53 / $168.53 / $309.08	Facility	26	$168.53	$168.53	$309.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $409.51 / $409.51 / $932.48	Professional		$409.51	$409.51	$932.48
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $168.53 / $168.53 / $168.53	Professional	26	$168.53	$168.53	$168.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $440.80 / $1,058.90	Professional		$3.00	$440.80	$1,058.90
United Facility/Professional Facility Modifier Low / Median / High Price $905.00 / $2,417.00 / $4,102.00	Facility		$905.00	$2,417.00	$4,102.00
United Facility/Professional Professional Modifier Low / Median / High Price $322.32 / $486.56 / $1,031.69	Professional		$322.32	$486.56	$1,031.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $125.94 / $176.12 / $375.51	Professional	26	$125.94	$176.12	$375.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.97 / $292.30 / $648.17	Professional	TC	$199.97	$292.30	$648.17
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,043.98 / $1,891.36	Facility		$55.00	$1,043.98	$1,891.36
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $289.62 / $603.96 / $603.96	Facility	26	$289.62	$603.96	$603.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,582.80 / $3,019.05 / $3,019.05	Professional		$2,582.80	$3,019.05	$3,019.05
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $908.96 / $1,026.90 / $1,026.90	Professional	26	$908.96	$1,026.90	$1,026.90
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,745.64 / $1,992.15 / $1,992.15	Professional	TC	$1,745.64	$1,992.15	$1,992.15