Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.70 / $96.86 / $142.24	Facility	26	$84.70	$96.86	$142.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.35 / $425.00 / $1,111.50	Professional		$276.35	$425.00	$1,111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.70 / $118.59 / $249.97	Professional	26	$84.70	$118.59	$249.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $138.18 / $148.16 / $336.60	Professional	52	$138.18	$148.16	$336.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.65 / $282.87 / $526.15	Professional	TC	$191.65	$282.87	$526.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.57 / $85.07 / $177.23	Professional	26	$62.57	$85.07	$177.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.20 / $223.20 / $223.20	Professional		$223.20	$223.20	$223.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $140.97 / $207.36 / $257.91	Professional	26	$140.97	$207.36	$257.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $494.26 / $754.63 / $1,033.11	Professional	TC	$494.26	$754.63	$1,033.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.02 / $692.76 / $1,406.71	Professional		$362.02	$692.76	$1,406.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $139.35 / $244.46	Professional	26	$81.95	$139.35	$244.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.64 / $531.14 / $1,161.88	Professional	TC	$249.64	$531.14	$1,161.88
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $128.43 / $148.00 / $260.91	Facility	26	$128.43	$148.00	$260.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $287.00 / $550.00	Professional		$113.00	$287.00	$550.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $128.43 / $128.43 / $311.70	Professional	26	$128.43	$128.43	$311.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $275.51 / $457.67	Professional		$86.24	$275.51	$457.67
United Facility/Professional Professional Modifier Low / Median / High Price $297.45 / $565.00 / $915.22	Professional		$297.45	$565.00	$915.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.77 / $118.10 / $241.06	Professional	26	$85.77	$118.10	$241.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.63 / $415.32 / $645.49	Professional	TC	$206.63	$415.32	$645.49
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $612.55 / $771.20 / $771.20	Facility	26	$612.55	$771.20	$771.20
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,548.99 / $3,548.99 / $3,548.99	Professional		$3,548.99	$3,548.99	$3,548.99
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $672.00 / $672.00 / $675.90	Professional	26	$672.00	$672.00	$675.90
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $3,086.80 / $3,086.80 / $3,086.80	Professional	TC	$3,086.80	$3,086.80	$3,086.80