Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $91.59 / $139.44	Facility	26	$83.00	$91.59	$139.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.15 / $320.47 / $1,123.53	Professional		$252.15	$320.47	$1,123.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.17 / $90.20 / $262.69	Professional	26	$74.17	$90.20	$262.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $280.51 / $520.14	Professional	TC	$169.13	$280.51	$520.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.03 / $483.96 / $633.78	Professional		$209.03	$483.96	$633.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.76 / $127.38 / $173.70	Professional	26	$61.76	$127.38	$173.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $260.60 / $260.60	Professional	TC	$162.63	$260.60	$260.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.65 / $218.65 / $218.65	Professional		$218.65	$218.65	$218.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.43 / $206.13 / $253.26	Professional	26	$138.43	$206.13	$253.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.75 / $654.58 / $856.57	Professional	TC	$426.75	$654.58	$856.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $366.03 / $615.95 / $1,248.47	Professional		$366.03	$615.95	$1,248.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.47 / $136.84 / $239.17	Professional	26	$80.47	$136.84	$239.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.91 / $473.00 / $1,050.08	Professional	TC	$254.91	$473.00	$1,050.08
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $126.86 / $144.00 / $250.40	Facility	26	$126.86	$144.00	$250.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $255.00 / $368.00	Professional		$111.00	$255.00	$368.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $126.86 / $126.86 / $144.00	Professional	26	$126.86	$126.86	$144.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $622.40 / $622.40 / $622.40	Professional	TC	$622.40	$622.40	$622.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.42 / $251.96 / $459.87	Professional		$83.42	$251.96	$459.87
United Facility/Professional Professional Modifier Low / Median / High Price $286.27 / $542.42 / $886.01	Professional		$286.27	$542.42	$886.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.22 / $115.78 / $236.15	Professional	26	$84.22	$115.78	$236.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.89 / $441.66 / $657.46	Professional	TC	$196.89	$441.66	$657.46
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $600.40 / $755.84 / $755.84	Facility	26	$600.40	$755.84	$755.84
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,893.96 / $3,234.12 / $3,234.12	Professional		$2,893.96	$3,234.12	$3,234.12
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $559.72 / $559.72 / $662.48	Professional	26	$559.72	$559.72	$662.48
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,441.41 / $2,752.56 / $2,752.56	Professional	TC	$2,441.41	$2,752.56	$2,752.56