Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.12 / $73.05 / $111.56	Facility	26	$64.12	$73.05	$111.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.32 / $423.95 / $945.60	Professional		$232.32	$423.95	$945.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.12 / $116.66 / $200.20	Professional	26	$64.12	$116.66	$200.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.20 / $299.00 / $541.46	Professional	TC	$168.20	$299.00	$541.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.08 / $64.08 / $64.08	Professional	26	$64.08	$64.08	$64.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.12 / $167.12 / $167.12	Professional		$167.12	$167.12	$167.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.97 / $152.38 / $194.09	Professional	26	$103.97	$152.38	$194.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $437.81 / $657.78 / $898.33	Professional	TC	$437.81	$657.78	$898.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.57 / $588.76 / $1,147.49	Professional		$307.57	$588.76	$1,147.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $104.98 / $184.04	Professional	26	$61.72	$104.98	$184.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.07 / $466.17 / $1,006.67	Professional	TC	$228.07	$466.17	$1,006.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.11 / $111.00 / $200.00	Facility	26	$97.11	$111.00	$200.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $292.00 / $378.00	Professional		$85.00	$292.00	$378.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $97.11 / $97.11 / $235.96	Professional	26	$97.11	$97.11	$235.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.97 / $245.01 / $409.73	Professional		$89.97	$245.01	$409.73
United Facility/Professional Professional Modifier Low / Median / High Price $249.27 / $476.82 / $898.84	Professional		$249.27	$476.82	$898.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $88.70 / $183.73	Professional	26	$64.48	$88.70	$183.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.58 / $389.77 / $723.31	Professional	TC	$191.58	$389.77	$723.31
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $461.28 / $580.79 / $580.79	Facility	26	$461.28	$580.79	$580.79
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,873.43 / $2,896.26 / $2,896.26	Professional		$2,873.43	$2,896.26	$2,896.26
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $625.77 / $625.77 / $625.77	Professional	26	$625.77	$625.77	$625.77
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,524.69 / $2,524.69 / $2,524.69	Professional	TC	$2,524.69	$2,524.69	$2,524.69