Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.32 / $65.01 / $126.00	Facility	26	$57.32	$65.01	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.07 / $414.65 / $872.73	Professional		$220.07	$414.65	$872.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.32 / $118.59 / $286.00	Professional	26	$57.32	$118.59	$286.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.75 / $306.97 / $507.22	Professional	TC	$162.75	$306.97	$507.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.01 / $545.39 / $545.39	Professional		$163.01	$545.39	$545.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.51 / $48.02 / $119.41	Professional	26	$42.51	$48.02	$119.41
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 $94.31 / $143.75 / $172.54	Professional	26	$94.31	$143.75	$172.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $428.10 / $657.29 / $894.84	Professional	TC	$428.10	$657.29	$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 $298.89 / $627.60 / $1,208.33	Professional		$298.89	$627.60	$1,208.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $93.33 / $164.84	Professional	26	$54.98	$93.33	$164.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.84 / $487.02 / $1,065.60	Professional	TC	$218.84	$487.02	$1,065.60
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $86.39 / $99.00 / $177.15	Facility	26	$86.39	$99.00	$177.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $415.00 / $492.00	Professional		$76.00	$415.00	$492.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $99.00 / $210.94 / $210.94	Professional	26	$99.00	$210.94	$210.94
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $485.00 / $485.00 / $485.00	Professional	TC	$485.00	$485.00	$485.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $240.44 / $393.11	Professional		$80.00	$240.44	$393.11
United Facility/Professional Professional Modifier Low / Median / High Price $250.10 / $480.68 / $934.68	Professional		$250.10	$480.68	$934.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.02 / $81.63 / $161.33	Professional	26	$56.02	$81.63	$161.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.39 / $397.12 / $784.83	Professional	TC	$188.39	$397.12	$784.83
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $412.32 / $519.52 / $519.52	Facility	26	$412.32	$519.52	$519.52
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,882.90 / $2,976.23 / $2,976.23	Professional		$2,882.90	$2,976.23	$2,976.23
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 / $2,703.83 / $2,703.83	Professional	TC	$2,573.94	$2,703.83	$2,703.83