Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $107.15 / $239.88	Facility	26	$70.79	$107.15	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $1,584.89	Professional		$331.13	$478.63	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $144.54 / $323.59	Professional	26	$70.79	$144.54	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $1,174.90	Professional	TC	$263.03	$354.81	$1,174.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $331.13 / $831.76	Professional		$245.47	$331.13	$831.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $93.33 / $158.49	Professional	26	$61.66	$93.33	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $208.93 / $239.88	Professional	26	$138.04	$208.93	$239.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $1,230.27 / $1,412.54	Professional	TC	$676.08	$1,230.27	$1,412.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $933.25 / $1,737.80	Professional		$407.38	$933.25	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $125.89 / $223.87	Professional	26	$63.10	$125.89	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $794.33 / $1,548.82	Professional	TC	$323.59	$794.33	$1,548.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	26	$158.49	$158.49	$158.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $309.03 / $707.95	Professional		$70.79	$309.03	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $741.31 / $1,412.54	Professional		$354.81	$741.31	$1,412.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $97.72 / $186.21	Professional	26	$72.44	$97.72	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $588.84 / $1,202.26	Professional	TC	$288.40	$588.84	$1,202.26
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	26	$645.65	$645.65	$645.65
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Professional		$5,495.41	$5,495.41	$5,495.41
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $812.83 / $812.83 / $812.83	Professional	26	$812.83	$812.83	$812.83
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,011.87 / $5,011.87 / $5,011.87	Professional	TC	$5,011.87	$5,011.87	$5,011.87