Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.32 / $70.48 / $126.00	Facility	26	$57.32	$70.48	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.42 / $400.00 / $651.04	Professional		$219.42	$400.00	$651.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.32 / $116.42 / $298.80	Professional	26	$57.32	$116.42	$298.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.10 / $282.87 / $506.52	Professional	TC	$162.10	$282.87	$506.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.52 / $214.58 / $544.60	Professional		$162.52	$214.58	$544.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.27 / $87.07 / $143.05	Professional	26	$42.27	$87.07	$143.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.38 / $149.38 / $149.38	Professional		$149.38	$149.38	$149.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.90 / $142.13 / $173.62	Professional	26	$94.90	$142.13	$173.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $427.25 / $678.24 / $894.84	Professional	TC	$427.25	$678.24	$894.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.77 / $625.10 / $1,211.50	Professional		$297.77	$625.10	$1,211.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.20 / $93.33 / $164.84	Professional	26	$55.20	$93.33	$164.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.01 / $487.02 / $1,065.60	Professional	TC	$218.01	$487.02	$1,065.60
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $86.39 / $116.00 / $176.14	Facility	26	$86.39	$116.00	$176.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $413.00 / $489.00	Professional		$76.00	$413.00	$489.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $86.39 / $86.39 / $116.00	Professional	26	$86.39	$86.39	$116.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $596.53 / $596.53 / $596.53	Professional	TC	$596.53	$596.53	$596.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $220.23 / $359.95	Professional		$57.56	$220.23	$359.95
United Facility/Professional Professional Modifier Low / Median / High Price $249.02 / $484.61 / $888.44	Professional		$249.02	$484.61	$888.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.96 / $83.70 / $157.04	Professional	26	$52.96	$83.70	$157.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $187.67 / $377.74 / $780.65	Professional	TC	$187.67	$377.74	$780.65
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $409.92 / $516.48 / $516.48	Facility	26	$409.92	$516.48	$516.48
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,885.07 / $2,983.73 / $2,983.73	Professional		$2,885.07	$2,983.73	$2,983.73
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $505.24 / $505.24 / $505.24	Professional	26	$505.24	$505.24	$505.24
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,573.94 / $2,710.11 / $2,710.11	Professional	TC	$2,573.94	$2,710.11	$2,710.11