Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.79 / $75.06 / $110.40	Facility	26	$65.79	$75.06	$110.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.80 / $281.16 / $916.00	Professional		$187.80	$281.16	$916.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $88.06 / $247.37	Professional	26	$59.34	$88.06	$247.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.00 / $212.33 / $453.68	Professional	TC	$122.00	$212.33	$453.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $183.99 / $467.06	Professional		$139.44	$183.99	$467.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.72 / $87.44 / $164.43	Professional	26	$48.72	$87.44	$164.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.57 / $87.57 / $208.80	Professional	TC	$87.57	$87.57	$208.80
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 $109.21 / $159.60 / $199.80	Professional	26	$109.21	$159.60	$199.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $311.95 / $435.45 / $678.04	Professional	TC	$311.95	$435.45	$678.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.01 / $398.63 / $684.05	Professional		$246.01	$398.63	$684.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.51 / $107.29 / $189.19	Professional	26	$63.51	$107.29	$189.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.83 / $285.63 / $534.61	Professional	TC	$156.83	$285.63	$534.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $99.69 / $134.00 / $198.80	Facility	26	$99.69	$134.00	$198.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $206.00 / $294.00	Professional		$88.00	$206.00	$294.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $99.69 / $99.69 / $134.00	Professional	26	$99.69	$99.69	$134.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $448.96 / $448.96 / $448.96	Professional	TC	$448.96	$448.96	$448.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.89 / $178.77 / $313.45	Professional		$66.89	$178.77	$313.45
United Facility/Professional Professional Modifier Low / Median / High Price $195.42 / $325.07 / $599.72	Professional		$195.42	$325.07	$599.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.34 / $96.58 / $185.71	Professional	26	$66.34	$96.58	$185.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.72 / $238.37 / $395.32	Professional	TC	$131.72	$238.37	$395.32
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $473.36 / $596.24 / $596.24	Facility	26	$473.36	$596.24	$596.24
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,657.47 / $1,680.90 / $1,680.90	Professional		$1,657.47	$1,680.90	$1,680.90
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $414.94 / $414.94 / $522.08	Professional	26	$414.94	$414.94	$522.08
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,425.00 / $1,425.00 / $1,425.00	Professional	TC	$1,425.00	$1,425.00	$1,425.00