Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $78.48 / $115.49	Facility	26	$75.86	$78.48	$115.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.85 / $275.00 / $712.36	Professional		$225.85	$275.00	$712.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $76.92 / $220.40	Professional	26	$62.17	$76.92	$220.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.94 / $202.55 / $405.30	Professional	TC	$148.94	$202.55	$405.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $166.61 / $167.20 / $167.20	Professional		$166.61	$167.20	$167.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $82.09 / $141.05	Professional	26	$57.10	$82.09	$141.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.97 / $257.97 / $257.97	Professional	TC	$257.97	$257.97	$257.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.23 / $180.23 / $180.23	Professional		$180.23	$180.23	$180.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.28 / $157.13 / $221.64	Professional	26	$114.28	$157.13	$221.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $379.39 / $525.41 / $839.32	Professional	TC	$379.39	$525.41	$839.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.87 / $478.20 / $828.24	Professional		$295.87	$478.20	$828.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.03 / $117.54 / $203.82	Professional	26	$69.03	$117.54	$203.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.07 / $353.11 / $670.54	Professional	TC	$192.07	$353.11	$670.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $104.39 / $119.00 / $214.63	Facility	26	$104.39	$119.00	$214.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $255.00 / $347.00	Professional		$92.00	$255.00	$347.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $104.39 / $104.39 / $283.07	Professional	26	$104.39	$104.39	$283.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $203.85 / $370.24	Professional		$77.73	$203.85	$370.24
United Facility/Professional Professional Modifier Low / Median / High Price $235.86 / $394.76 / $727.16	Professional		$235.86	$394.76	$727.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.67 / $108.05 / $213.00	Professional	26	$69.67	$108.05	$213.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.34 / $290.85 / $492.82	Professional	TC	$161.34	$290.85	$492.82
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $553.91 / $697.76 / $697.76	Facility	26	$553.91	$697.76	$697.76
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,997.15 / $2,036.01 / $2,036.01	Professional		$1,997.15	$2,036.01	$2,036.01
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $484.69 / $484.69 / $610.73	Professional	26	$484.69	$484.69	$610.73
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,005.00 / $2,005.00 / $2,005.00	Professional	TC	$2,005.00	$2,005.00	$2,005.00