Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.18 / $77.00 / $126.00	Facility	26	$70.18	$77.00	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.70 / $425.00 / $1,320.50	Professional		$273.70	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.18 / $117.22 / $202.39	Professional	26	$70.18	$117.22	$202.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.53 / $299.00 / $649.47	Professional	TC	$203.53	$299.00	$649.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.53 / $673.40 / $673.40	Professional		$197.53	$673.40	$673.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $128.03 / $128.03 / $128.03	Professional	26	$128.03	$128.03	$128.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $310.31 / $310.31 / $310.31	Professional	TC	$310.31	$310.31	$310.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.48 / $184.48 / $184.48	Professional		$184.48	$184.48	$184.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.49 / $174.14 / $213.29	Professional	26	$113.49	$174.14	$213.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $466.59 / $625.54 / $808.75	Professional	TC	$466.59	$625.54	$808.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.91 / $79.91 / $79.91	Facility	26	$79.91	$79.91	$79.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.72 / $621.27 / $1,091.57	Professional		$349.72	$621.27	$1,091.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $114.66 / $201.46	Professional	26	$67.73	$114.66	$201.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.76 / $488.70 / $938.95	Professional	TC	$261.76	$488.70	$938.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $106.80 / $123.00 / $200.06	Facility	26	$106.80	$123.00	$200.06
Medcost Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $308.00 / $450.00	Professional		$93.00	$308.00	$450.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $106.80 / $106.80 / $258.26	Professional	26	$106.80	$106.80	$258.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $430.10 / $683.20 / $766.90	Professional		$430.10	$683.20	$766.90
United Facility/Professional Professional Modifier Low / Median / High Price $303.48 / $501.75 / $840.28	Professional		$303.48	$501.75	$840.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.31 / $94.99 / $199.49	Professional	26	$69.31	$94.99	$199.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.72 / $402.54 / $660.85	Professional	TC	$220.72	$402.54	$660.85
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $505.36 / $635.84 / $635.84	Facility	26	$505.36	$635.84	$635.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,958.99 / $2,958.99 / $2,958.99	Professional		$2,958.99	$2,958.99	$2,958.99
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $548.98 / $548.98 / $557.63	Professional	26	$548.98	$548.98	$557.63
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,573.94 / $2,573.94 / $2,573.94	Professional	TC	$2,573.94	$2,573.94	$2,573.94