Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.36 / $72.17 / $109.87	Facility	26	$53.36	$72.17	$109.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.07 / $275.00 / $466.36	Professional		$183.07	$275.00	$466.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.37 / $68.16 / $157.51	Professional	26	$53.37	$68.16	$157.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.71 / $220.00 / $339.73	Professional	TC	$129.71	$220.00	$339.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $82.35 / $119.98	Professional	26	$39.93	$82.35	$119.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.95 / $171.95 / $171.95	Professional		$171.95	$171.95	$171.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.31 / $161.07 / $199.80	Professional	26	$106.31	$161.07	$199.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $498.74 / $716.47	Professional	TC	$316.23	$498.74	$716.47
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 $258.02 / $412.14 / $760.78	Professional		$258.02	$412.14	$760.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $101.74 / $175.33	Professional	26	$59.00	$101.74	$175.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.95 / $316.75 / $576.86	Professional	TC	$184.95	$316.75	$576.86
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $98.79 / $114.00 / $170.20	Facility	26	$98.79	$114.00	$170.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $257.00 / $344.00	Professional		$88.00	$257.00	$344.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $99.69 / $99.69 / $196.40	Professional	26	$99.69	$99.69	$196.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $180.30 / $318.95	Professional		$54.52	$180.30	$318.95
United Facility/Professional Professional Modifier Low / Median / High Price $220.19 / $355.03 / $607.83	Professional		$220.19	$355.03	$607.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.74 / $86.81 / $172.49	Professional	26	$57.74	$86.81	$172.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.35 / $275.36 / $469.25	Professional	TC	$157.35	$275.36	$469.25
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 $1,657.47 / $1,940.92 / $1,940.92	Professional		$1,657.47	$1,940.92	$1,940.92
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $428.03 / $556.79 / $556.79	Professional	26	$428.03	$556.79	$556.79
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,335.80 / $1,561.11 / $1,561.11	Professional	TC	$1,335.80	$1,561.11	$1,561.11