Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.29 / $259.39 / $4,311.00	Facility		$23.29	$259.39	$4,311.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.94 / $62.29 / $64.38	Facility	26	$38.94	$62.29	$64.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $221.87 / $487.57	Professional		$152.68	$221.87	$487.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.94 / $44.44 / $109.52	Professional	26	$38.94	$44.44	$109.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $152.87 / $299.27	Professional	TC	$98.17	$152.87	$299.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.72 / $219.72 / $303.66	Professional		$219.72	$219.72	$303.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $101.22 / $121.67	Professional	26	$58.24	$101.22	$121.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.65 / $227.85 / $349.97	Professional	TC	$142.65	$227.85	$349.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.92 / $315.14 / $440.52	Professional		$193.92	$315.14	$440.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.76 / $81.39 / $123.33	Professional	26	$52.76	$81.39	$123.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.97 / $219.88 / $315.70	Professional	TC	$129.97	$219.88	$315.70
Medcost Facility/Professional Facility Modifier Low / Median / High Price $173.42 / $259.29 / $464.67	Facility		$173.42	$259.29	$464.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $57.25 / $102.14 / $125.00	Facility	26	$57.25	$102.14	$125.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $180.46 / $180.46 / $404.06	Professional		$180.46	$180.46	$404.06
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $57.25 / $57.25 / $57.25	Professional	26	$57.25	$57.25	$57.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $210.30 / $366.60 / $541.79	Professional		$210.30	$366.60	$541.79
United Facility/Professional Facility Modifier Low / Median / High Price $361.00 / $896.00 / $2,229.00	Facility		$361.00	$896.00	$2,229.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.13 / $215.63 / $496.68	Professional		$136.13	$215.63	$496.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.31 / $60.00 / $119.90	Professional	26	$40.31	$60.00	$119.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.75 / $159.80 / $285.02	Professional	TC	$91.75	$159.80	$285.02
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $499.68 / $2,922.50	Facility		$55.00	$499.68	$2,922.50
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $101.27 / $190.52 / $190.52	Facility	26	$101.27	$190.52	$190.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,577.95 / $1,577.95 / $1,577.95	Professional		$1,577.95	$1,577.95	$1,577.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $684.00 / $907.84 / $907.84	Professional	26	$684.00	$907.84	$907.84
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,150.75 / $1,150.75 / $1,150.75	Professional	TC	$1,150.75	$1,150.75	$1,150.75