Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $114.82 / $269.15	Facility	26	$77.62	$114.82	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $1,000.00	Professional		$218.78	$309.03	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $114.82 / $229.09	Professional	26	$64.57	$114.82	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $524.81	Professional	TC	$141.25	$218.78	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $181.97	Professional		$169.82	$177.83	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $125.89	Professional	26	$67.61	$79.43	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $158.49 / $223.87	Professional	26	$112.20	$158.49	$223.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $524.81 / $831.76	Professional	TC	$331.13	$524.81	$831.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $457.09 / $776.25	Professional		$263.03	$457.09	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $112.20 / $199.53	Professional	26	$66.07	$112.20	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $331.13 / $588.84	Professional	TC	$173.78	$331.13	$588.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	26	$125.89	$125.89	$125.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $204.17 / $436.52	Professional		$75.86	$204.17	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $363.08 / $630.96	Professional		$234.42	$363.08	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $91.20 / $181.97	Professional	26	$69.18	$91.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $275.42 / $446.68	Professional	TC	$154.88	$275.42	$446.68
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $691.83 / $691.83 / $691.83	Facility	26	$691.83	$691.83	$691.83
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,041.74 / $2,041.74	Professional		$1,995.26	$2,041.74	$2,041.74
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $489.78 / $489.78 / $616.60	Professional	26	$489.78	$489.78	$616.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional	TC	$1,995.26	$1,995.26	$1,995.26