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 / $302.87 / $1,036.42	Professional		$252.15	$302.87	$1,036.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.34 / $88.35 / $256.58	Professional	26	$73.34	$88.35	$256.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $263.66 / $463.65	Professional	TC	$169.13	$263.66	$463.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.79 / $241.98 / $633.78	Professional		$137.79	$241.98	$633.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.76 / $98.43 / $173.70	Professional	26	$61.76	$98.43	$173.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $129.40 / $129.40 / $162.63	Professional	TC	$129.40	$129.40	$162.63
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 $138.04 / $206.13 / $254.13	Professional	26	$138.04	$206.13	$254.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.75 / $590.02 / $856.57	Professional	TC	$426.75	$590.02	$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 $365.61 / $617.11 / $1,280.77	Professional		$365.61	$617.11	$1,280.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.81 / $136.84 / $239.66	Professional	26	$80.81	$136.84	$239.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.49 / $474.88 / $1,058.42	Professional	TC	$254.49	$474.88	$1,058.42
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $127.02 / $145.00 / $250.40	Facility	26	$127.02	$145.00	$250.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $254.00 / $368.00	Professional		$111.00	$254.00	$368.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $127.02 / $127.02 / $145.00	Professional	26	$127.02	$127.02	$145.00
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 $84.56 / $251.67 / $459.87	Professional		$84.56	$251.67	$459.87
United Facility/Professional Professional Modifier Low / Median / High Price $283.97 / $538.29 / $893.81	Professional		$283.97	$538.29	$893.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.76 / $113.17 / $235.70	Professional	26	$82.76	$113.17	$235.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.74 / $412.76 / $689.37	Professional	TC	$196.74	$412.76	$689.37
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 / $3,248.56 / $3,248.56	Professional		$2,893.96	$3,248.56	$3,248.56
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $662.48 / $880.00 / $880.00	Professional	26	$662.48	$880.00	$880.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,441.41 / $2,765.07 / $2,765.07	Professional	TC	$2,441.41	$2,765.07	$2,765.07