Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.00 / $62.65 / $95.38	Facility	26	$57.00	$62.65	$95.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.31 / $400.00 / $750.52	Professional		$231.31	$400.00	$750.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.00 / $85.00 / $173.76	Professional	26	$57.00	$85.00	$173.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.31 / $281.41 / $565.10	Professional	TC	$174.31	$281.41	$565.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $171.15	Professional		$171.15	$171.15	$171.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $118.73 / $118.73	Professional	26	$41.94	$118.73	$118.73
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 / $146.84 / $173.62	Professional	26	$94.90	$146.84	$173.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $478.86 / $749.12 / $1,033.69	Professional	TC	$478.86	$749.12	$1,033.69
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 $313.60 / $627.60 / $1,206.76	Professional		$313.60	$627.60	$1,206.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.20 / $93.33 / $163.92	Professional	26	$55.20	$93.33	$163.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.01 / $507.49 / $1,065.60	Professional	TC	$231.01	$507.49	$1,065.60
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $79.00 / $94.34 / $204.00	Facility	26	$79.00	$94.34	$204.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $409.00 / $550.00	Professional		$76.00	$409.00	$550.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $86.39 / $86.39 / $209.76	Professional	26	$86.39	$86.39	$209.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $231.98 / $379.01	Professional		$57.56	$231.98	$379.01
United Facility/Professional Professional Modifier Low / Median / High Price $257.99 / $473.75 / $972.49	Professional		$257.99	$473.75	$972.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.70 / $79.48 / $156.34	Professional	26	$55.70	$79.48	$156.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.86 / $413.71 / $772.30	Professional	TC	$198.86	$413.71	$772.30
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 $2,882.90 / $2,972.47 / $2,972.47	Professional		$2,882.90	$2,972.47	$2,972.47
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $596.05 / $596.05 / $596.05	Professional	26	$596.05	$596.05	$596.05
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,573.94 / $2,698.84 / $2,698.84	Professional	TC	$2,573.94	$2,698.84	$2,698.84