Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.50 / $58.57 / $83.28	Facility	26	$40.50	$58.57	$83.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.09 / $226.80 / $673.00	Professional		$129.09	$226.80	$673.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $55.04 / $160.62	Professional	26	$39.65	$55.04	$160.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.69 / $64.55 / $137.50	Professional	52	$63.69	$64.55	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.60 / $177.61 / $298.41	Professional	TC	$88.60	$177.61	$298.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.87 / $236.86 / $323.37	Professional		$96.87	$236.86	$323.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $56.51 / $102.10	Professional	26	$30.35	$56.51	$102.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $68.42 / $68.42 / $193.18	Professional	TC	$68.42	$68.42	$193.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.02 / $142.02 / $142.02	Professional		$142.02	$142.02	$142.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.37 / $124.44 / $149.00	Professional	26	$85.37	$124.44	$149.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.66 / $327.45 / $494.51	Professional	TC	$221.66	$327.45	$494.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.27 / $46.27 / $46.27	Facility	26	$46.27	$46.27	$46.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.12 / $300.88 / $571.78	Professional		$169.12	$300.88	$571.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.61 / $79.20 / $129.57	Professional	26	$44.61	$79.20	$129.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.04 / $217.07 / $447.79	Professional	TC	$115.04	$217.07	$447.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $77.94 / $111.00 / $155.00	Facility	26	$77.94	$111.00	$155.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $120.00 / $225.00	Professional		$54.00	$120.00	$225.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $81.87 / $81.87 / $149.04	Professional	26	$81.87	$81.87	$149.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $118.46 / $218.50	Professional		$42.16	$118.46	$218.50
United Facility/Professional Professional Modifier Low / Median / High Price $133.65 / $249.15 / $419.30	Professional		$133.65	$249.15	$419.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $66.05 / $127.38	Professional	26	$42.78	$66.05	$127.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.56 / $181.32 / $298.70	Professional	TC	$90.56	$181.32	$298.70
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $295.27 / $371.60 / $371.60	Facility	26	$295.27	$371.60	$371.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,379.07 / $1,413.47 / $1,413.47	Professional		$1,379.07	$1,413.47	$1,413.47
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $333.52 / $333.52 / $333.52	Professional	26	$333.52	$333.52	$333.52
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,220.00 / $1,220.00 / $1,220.00	Professional	TC	$1,220.00	$1,220.00	$1,220.00