Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.04 / $75.50 / $102.10	Facility	26	$61.04	$75.50	$102.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.88 / $259.57 / $721.63	Professional		$160.88	$259.57	$721.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $65.15 / $179.22	Professional	26	$55.15	$65.15	$179.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.84 / $171.36 / $344.54	Professional	TC	$99.84	$171.36	$344.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.81 / $294.72 / $294.72	Professional		$120.81	$294.72	$294.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.83 / $80.84 / $127.73	Professional	26	$46.83	$80.84	$127.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $212.41 / $212.41 / $471.25	Professional	TC	$212.41	$212.41	$471.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.02 / $160.02 / $160.02	Professional		$160.02	$160.02	$160.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.02 / $146.32 / $184.82	Professional	26	$101.02	$146.32	$184.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $236.34 / $330.86 / $495.45	Professional	TC	$236.34	$330.86	$495.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.78 / $356.72 / $652.28	Professional		$225.78	$356.72	$652.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $99.77 / $174.67	Professional	26	$58.71	$99.77	$174.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.78 / $263.67 / $482.20	Professional	TC	$145.78	$263.67	$482.20
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $92.09 / $106.00 / $170.80	Facility	26	$92.09	$106.00	$170.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $210.00 / $291.00	Professional		$81.00	$210.00	$291.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $92.09 / $92.09 / $224.66	Professional	26	$92.09	$92.09	$224.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.62 / $139.83 / $282.19	Professional		$61.62	$139.83	$282.19
United Facility/Professional Professional Modifier Low / Median / High Price $193.07 / $305.05 / $534.35	Professional		$193.07	$305.05	$534.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.71 / $84.66 / $169.82	Professional	26	$61.71	$84.66	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.08 / $230.09 / $380.00	Professional	TC	$134.08	$230.09	$380.00
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $441.84 / $555.91 / $555.91	Facility	26	$441.84	$555.91	$555.91
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,417.13 / $1,670.68 / $1,670.68	Professional		$1,417.13	$1,670.68	$1,670.68
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $487.80 / $520.49 / $520.49	Professional	26	$487.80	$520.49	$520.49
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,128.24 / $1,318.41 / $1,318.41	Professional	TC	$1,128.24	$1,318.41	$1,318.41