Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.71 / $74.65 / $101.54	Facility	26	$60.71	$74.65	$101.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.59 / $256.83 / $442.82	Professional		$176.59	$256.83	$442.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $61.17 / $177.21	Professional	26	$54.86	$61.17	$177.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.90 / $201.68 / $313.58	Professional	TC	$115.90	$201.68	$313.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.90 / $131.50 / $333.90	Professional		$130.90	$131.50	$333.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.00 / $64.69 / $121.28	Professional	26	$45.00	$64.69	$121.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.01 / $103.01 / $103.01	Professional	TC	$103.01	$103.01	$103.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.22 / $158.22 / $158.22	Professional		$158.22	$158.22	$158.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.38 / $144.83 / $183.64	Professional	26	$100.38	$144.83	$183.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $311.72 / $463.45 / $749.47	Professional	TC	$311.72	$463.45	$749.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $410.51 / $712.07	Professional		$222.36	$410.51	$712.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.33 / $99.23 / $173.68	Professional	26	$58.33	$99.23	$173.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.28 / $291.31 / $564.09	Professional	TC	$149.28	$291.31	$564.09
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.56 / $131.83 / $213.00	Facility	26	$91.56	$131.83	$213.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $159.00 / $275.00	Professional		$81.00	$159.00	$275.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $91.56 / $91.56 / $223.41	Professional	26	$91.56	$91.56	$223.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.26 / $162.38 / $289.87	Professional		$75.26	$162.38	$289.87
United Facility/Professional Professional Modifier Low / Median / High Price $183.34 / $327.20 / $525.24	Professional		$183.34	$327.20	$525.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $82.28 / $170.88	Professional	26	$61.32	$82.28	$170.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.09 / $231.77 / $357.45	Professional	TC	$120.09	$231.77	$357.45
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $436.88 / $549.76 / $549.76	Facility	26	$436.88	$549.76	$549.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,954.49 / $1,954.49 / $1,954.49	Professional		$1,954.49	$1,954.49	$1,954.49
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $435.88 / $435.88 / $482.33	Professional	26	$435.88	$435.88	$482.33
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,624.23 / $1,624.23 / $1,624.23	Professional	TC	$1,624.23	$1,624.23	$1,624.23