Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.17 / $46.48 / $83.00	Facility	26	$40.17	$46.48	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.66 / $178.59 / $648.41	Professional		$104.66	$178.59	$648.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.46 / $43.85 / $121.26	Professional	26	$36.46	$43.85	$121.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.68 / $111.55 / $263.31	Professional	TC	$62.68	$111.55	$263.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $137.94 / $268.11	Professional		$81.06	$137.94	$268.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.11 / $62.11 / $102.10	Professional	26	$30.11	$62.11	$102.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.95 / $91.95 / $91.95	Professional	TC	$91.95	$91.95	$91.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.55 / $106.55 / $106.55	Professional		$106.55	$106.55	$106.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.33 / $99.49 / $123.17	Professional	26	$67.33	$99.49	$123.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $193.86 / $310.12 / $481.64	Professional	TC	$193.86	$310.12	$481.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.92 / $45.92 / $45.92	Facility	26	$45.92	$45.92	$45.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.65 / $262.20 / $472.30	Professional		$135.65	$262.20	$472.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.13 / $65.92 / $116.90	Professional	26	$39.13	$65.92	$116.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.51 / $176.50 / $382.03	Professional	TC	$85.51	$176.50	$382.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $61.62 / $100.00 / $145.00	Facility	26	$61.62	$100.00	$145.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $91.00 / $225.00	Professional		$54.00	$91.00	$225.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $61.62 / $61.62 / $100.00	Professional	26	$61.62	$61.62	$100.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $245.68 / $245.68 / $245.68	Professional	TC	$245.68	$245.68	$245.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $99.22 / $178.79	Professional		$50.45	$99.22	$178.79
United Facility/Professional Professional Modifier Low / Median / High Price $110.85 / $208.93 / $332.01	Professional		$110.85	$208.93	$332.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $56.25 / $113.54	Professional	26	$40.76	$56.25	$113.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.40 / $133.44 / $216.14	Professional	TC	$68.40	$133.44	$216.14
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $292.88 / $368.56 / $368.56	Facility	26	$292.88	$368.56	$368.56
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,305.85 / $1,305.85 / $1,305.85	Professional		$1,305.85	$1,305.85	$1,305.85
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $315.37 / $315.37 / $323.39	Professional	26	$315.37	$315.37	$323.39
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,108.00 / $1,108.00 / $1,108.00	Professional	TC	$1,108.00	$1,108.00	$1,108.00