Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $74.13 / $186.21	Facility	26	$53.70	$74.13	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $676.08	Professional		$181.97	$275.42	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $104.71 / $234.42	Professional	26	$52.48	$104.71	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $213.80 / $489.78	Professional	TC	$125.89	$213.80	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $120.23	Professional	26	$40.74	$56.23	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $162.18 / $199.53	Professional	26	$102.33	$162.18	$199.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $467.74 / $707.95	Professional	TC	$288.40	$467.74	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $60.26 / $87.10	Facility	26	$13.18	$60.26	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $398.11 / $724.44	Professional		$229.09	$398.11	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $95.50 / $169.82	Professional	26	$47.86	$95.50	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $295.12 / $562.34	Professional	TC	$165.96	$295.12	$562.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $165.96 / $354.81	Professional		$54.95	$165.96	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $588.84	Professional		$213.80	$331.13	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $154.88	Professional	26	$56.23	$79.43	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $257.04 / $436.52	Professional	TC	$158.49	$257.04	$436.52
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	26	$489.78	$489.78	$489.78
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,949.84 / $1,949.84	Professional		$1,659.59	$1,949.84	$1,949.84
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $562.34 / $562.34	Professional	26	$426.58	$562.34	$562.34
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,548.82 / $1,548.82	Professional	TC	$1,348.96	$1,548.82	$1,548.82