Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.69 / $61.50 / $89.86	Facility	26	$53.69	$61.50	$89.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.32 / $232.72 / $438.16	Professional		$150.32	$232.72	$438.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $54.20 / $155.43	Professional	26	$48.57	$54.20	$155.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.63 / $121.28 / $260.89	Professional	TC	$96.63	$121.28	$260.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $373.68 / $373.68 / $373.68	Professional		$373.68	$373.68	$373.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $49.26 / $112.30	Professional	26	$39.97	$49.26	$112.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.10 / $141.10 / $141.10	Professional		$141.10	$141.10	$141.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.84 / $132.18 / $164.35	Professional	26	$89.84	$132.18	$164.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.14 / $343.13 / $606.41	Professional	TC	$257.14	$343.13	$606.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.37 / $342.00 / $601.38	Professional		$185.37	$342.00	$601.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.23 / $87.76 / $154.44	Professional	26	$52.23	$87.76	$154.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.24 / $236.54 / $482.13	Professional	TC	$121.24	$236.54	$482.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $81.69 / $94.00 / $165.91	Facility	26	$81.69	$94.00	$165.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $131.00 / $225.00	Professional		$72.00	$131.00	$225.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $81.69 / $81.69 / $197.58	Professional	26	$81.69	$81.69	$197.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $139.18 / $245.65	Professional		$66.84	$139.18	$245.65
United Facility/Professional Professional Modifier Low / Median / High Price $156.54 / $269.11 / $446.95	Professional		$156.54	$269.11	$446.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $83.64 / $152.38	Professional	26	$54.53	$83.64	$152.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.30 / $191.68 / $293.52	Professional	TC	$100.30	$191.68	$293.52
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $388.00 / $488.64 / $488.64	Facility	26	$388.00	$488.64	$488.64
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,593.45 / $1,593.45 / $1,593.45	Professional		$1,593.45	$1,593.45	$1,593.45
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $363.24 / $363.24 / $428.03	Professional	26	$363.24	$363.24	$428.03
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,301.23 / $1,301.23 / $1,301.23	Professional	TC	$1,301.23	$1,301.23	$1,301.23