Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.64 / $138.84 / $1,856.19	Facility	26	$101.64	$138.84	$1,856.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.45 / $475.00 / $1,748.13	Professional		$348.45	$475.00	$1,748.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.64 / $141.82 / $498.26	Professional	26	$101.64	$141.82	$498.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $246.81 / $335.00 / $931.30	Professional	TC	$246.81	$335.00	$931.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $480.45 / $480.45 / $480.45	Professional		$480.45	$480.45	$480.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.78 / $109.78 / $186.71	Professional	26	$75.78	$109.78	$186.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.00 / $267.00 / $267.00	Professional		$267.00	$267.00	$267.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $164.51 / $240.60 / $309.17	Professional	26	$164.51	$240.60	$309.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $639.94 / $1,039.55 / $1,485.41	Professional	TC	$639.94	$1,039.55	$1,485.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.48 / $994.84 / $1,864.67	Professional		$456.48	$994.84	$1,864.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.23 / $166.61 / $293.45	Professional	26	$98.23	$166.61	$293.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.32 / $748.14 / $1,644.62	Professional	TC	$323.32	$748.14	$1,644.62
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $154.59 / $176.00 / $315.11	Facility	26	$154.59	$176.00	$315.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $384.00 / $750.00	Professional		$136.00	$384.00	$750.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $154.59 / $154.59 / $374.04	Professional	26	$154.59	$154.59	$374.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $357.66 / $616.36	Professional		$143.31	$357.66	$616.36
United Facility/Professional Professional Modifier Low / Median / High Price $372.60 / $719.35 / $1,258.81	Professional		$372.60	$719.35	$1,258.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.63 / $137.61 / $288.39	Professional	26	$103.63	$137.61	$288.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.16 / $534.72 / $1,023.08	Professional	TC	$267.16	$534.72	$1,023.08
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $742.64 / $932.32 / $932.32	Facility	26	$742.64	$932.32	$932.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,160.49 / $6,160.49 / $6,160.49	Professional		$6,160.49	$6,160.49	$6,160.49
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $883.52 / $883.52 / $883.52	Professional	26	$883.52	$883.52	$883.52
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,601.93 / $5,601.93 / $5,601.93	Professional	TC	$5,601.93	$5,601.93	$5,601.93