Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.70 / $128.07 / $1,725.83	Facility	26	$108.70	$128.07	$1,725.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $326.61 / $425.00 / $1,725.83	Professional		$326.61	$425.00	$1,725.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.69 / $162.28 / $439.23	Professional	26	$106.69	$162.28	$439.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $163.31 / $174.43 / $398.25	Professional	52	$163.31	$174.43	$398.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.91 / $335.00 / $848.83	Professional	TC	$217.91	$335.00	$848.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.29 / $589.94 / $1,295.55	Professional		$159.29	$589.94	$1,295.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.14 / $178.52 / $260.62	Professional	26	$81.14	$178.52	$260.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.83 / $330.08 / $330.08	Professional	TC	$154.83	$330.08	$330.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.00 / $295.00 / $295.00	Professional		$295.00	$295.00	$295.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $186.03 / $279.87 / $331.72	Professional	26	$186.03	$279.87	$331.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $630.39 / $1,124.13 / $1,475.46	Professional	TC	$630.39	$1,124.13	$1,475.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.88 / $123.88 / $123.88	Facility	26	$123.88	$123.88	$123.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.85 / $960.19 / $1,889.28	Professional		$427.85	$960.19	$1,889.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.20 / $183.97 / $316.08	Professional	26	$108.20	$183.97	$316.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.62 / $653.59 / $1,645.61	Professional	TC	$284.62	$653.59	$1,645.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $170.15 / $252.00 / $361.00	Facility	26	$170.15	$252.00	$361.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $326.00 / $750.00	Professional		$145.00	$326.00	$750.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $170.15 / $170.15 / $400.02	Professional	26	$170.15	$170.15	$400.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $111.49 / $316.87 / $541.60	Professional		$111.49	$316.87	$541.60
United Facility/Professional Professional Modifier Low / Median / High Price $358.49 / $702.84 / $1,328.75	Professional		$358.49	$702.84	$1,328.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.23 / $159.32 / $318.60	Professional	26	$113.23	$159.32	$318.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.49 / $461.09 / $981.19	Professional	TC	$235.49	$461.09	$981.19
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $791.52 / $993.60 / $993.60	Facility	26	$791.52	$993.60	$993.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,330.97 / $6,330.97 / $6,330.97	Professional		$6,330.97	$6,330.97	$6,330.97
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $921.60 / $921.60 / $921.60	Professional	26	$921.60	$921.60	$921.60
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,717.71 / $5,717.71 / $5,717.71	Professional	TC	$5,717.71	$5,717.71	$5,717.71