Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.71 / $106.18 / $144.00	Facility	26	$85.71	$106.18	$144.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.80 / $439.25 / $1,320.50	Professional		$351.80	$439.25	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.72 / $140.00 / $382.62	Professional	26	$85.72	$140.00	$382.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.08 / $335.00 / $861.14	Professional	TC	$266.08	$335.00	$861.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $260.33 / $260.33 / $260.33	Professional		$260.33	$260.33	$260.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.63 / $131.03 / $268.56	Professional	26	$63.63	$131.03	$268.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.05 / $225.05 / $225.05	Professional		$225.05	$225.05	$225.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $142.26 / $220.12 / $260.27	Professional	26	$142.26	$220.12	$260.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $689.25 / $1,234.01 / $1,389.80	Professional	TC	$689.25	$1,234.01	$1,389.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $475.93 / $1,027.58 / $2,044.36	Professional		$475.93	$1,027.58	$2,044.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.72 / $140.08 / $246.44	Professional	26	$82.72	$140.08	$246.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $352.69 / $866.99 / $1,844.86	Professional	TC	$352.69	$866.99	$1,844.86
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $129.50 / $149.00 / $265.23	Facility	26	$129.50	$149.00	$265.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $637.00 / $751.00	Professional		$114.00	$637.00	$751.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $149.00 / $315.45 / $315.45	Professional	26	$149.00	$315.45	$315.45
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $742.34 / $742.34 / $742.34	Professional	TC	$742.34	$742.34	$742.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $386.74 / $626.61	Professional		$120.00	$386.74	$626.61
United Facility/Professional Professional Modifier Low / Median / High Price $390.59 / $781.18 / $1,491.39	Professional		$390.59	$781.18	$1,491.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.77 / $125.34 / $234.15	Professional	26	$84.77	$125.34	$234.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.08 / $657.17 / $1,287.58	Professional	TC	$282.08	$657.17	$1,287.58
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $617.36 / $777.44 / $777.44	Facility	26	$617.36	$777.44	$777.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $5,470.52 / $5,470.52 / $5,470.52	Professional		$5,470.52	$5,470.52	$5,470.52
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $808.00 / $808.00 / $808.00	Professional	26	$808.00	$808.00	$808.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,004.77 / $5,004.77 / $5,004.77	Professional	TC	$5,004.77	$5,004.77	$5,004.77