Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $100.00 / $223.87	Facility	26	$64.57	$100.00	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $1,548.82	Professional		$251.19	$426.58	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $288.40	Professional	26	$70.79	$120.23	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $776.25	Professional	TC	$177.83	$302.00	$776.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $104.71 / $120.23	Professional	26	$66.07	$104.71	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $158.49 / $204.17	Professional	26	$93.33	$158.49	$204.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $660.69 / $1,023.29	Professional	TC	$467.74	$660.69	$1,023.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $81.28 / $114.82	Facility	26	$17.38	$81.28	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $616.60 / $1,122.02	Professional		$309.03	$616.60	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $100.00 / $186.21	Professional	26	$57.54	$100.00	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $501.19 / $977.24	Professional	TC	$218.78	$501.19	$977.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Professional		$776.25	$776.25	$776.25
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Professional	26	$104.71	$104.71	$104.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $229.09 / $537.03	Professional		$72.44	$229.09	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $501.19 / $891.25	Professional		$263.03	$501.19	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $158.49	Professional	26	$56.23	$81.28	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $398.11 / $776.25	Professional	TC	$190.55	$398.11	$776.25
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 $2,884.03 / $3,090.30 / $3,090.30	Professional		$2,884.03	$3,090.30	$3,090.30
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $602.56 / $870.96 / $870.96	Professional	26	$602.56	$870.96	$870.96
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,570.40 / $2,818.38 / $2,818.38	Professional	TC	$2,570.40	$2,818.38	$2,818.38