Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.04 / $83.00 / $102.56	Facility	26	$61.04	$83.00	$102.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.54 / $232.78 / $436.24	Professional		$152.54	$232.78	$436.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $63.49 / $175.04	Professional	26	$55.00	$63.49	$175.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.48 / $117.06 / $241.67	Professional	TC	$91.48	$117.06	$241.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.11 / $114.11 / $114.11	Professional		$114.11	$114.11	$114.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.50 / $93.67 / $152.47	Professional	26	$45.50	$93.67	$152.47
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 $101.62 / $147.71 / $185.90	Professional	26	$101.62	$147.71	$185.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.38 / $311.14 / $493.52	Professional	TC	$235.38	$311.14	$493.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.74 / $328.36 / $573.97	Professional		$197.74	$328.36	$573.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.06 / $99.77 / $175.49	Professional	26	$59.06	$99.77	$175.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.03 / $223.96 / $439.08	Professional	TC	$118.03	$223.96	$439.08
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $92.60 / $105.00 / $171.12	Facility	26	$92.60	$105.00	$171.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $160.00 / $241.00	Professional		$81.00	$160.00	$241.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $92.60 / $92.60 / $224.66	Professional	26	$92.60	$92.60	$224.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.51 / $127.68 / $256.92	Professional		$62.51	$127.68	$256.92
United Facility/Professional Professional Modifier Low / Median / High Price $162.59 / $276.83 / $475.29	Professional		$162.59	$276.83	$475.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.71 / $84.65 / $176.81	Professional	26	$61.71	$84.65	$176.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.96 / $182.54 / $302.99	Professional	TC	$98.96	$182.54	$302.99
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 / $1,417.13 / $1,417.13	Professional		$1,417.13	$1,417.13	$1,417.13
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $384.88 / $384.88 / $487.80	Professional	26	$384.88	$384.88	$487.80
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,332.00 / $1,332.00 / $1,332.00	Professional	TC	$1,332.00	$1,332.00	$1,332.00