Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.32 / $63.06 / $86.21	Facility	26	$51.32	$63.06	$86.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.57 / $178.05 / $629.94	Professional		$106.57	$178.05	$629.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.76 / $55.00 / $177.44	Professional	26	$45.76	$55.00	$177.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $67.23 / $67.23 / $137.50	Professional	52	$67.23	$67.23	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.75 / $159.05 / $362.62	Professional	TC	$79.75	$159.05	$362.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.01 / $246.78 / $336.52	Professional		$101.01	$246.78	$336.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $73.65 / $131.47	Professional	26	$38.15	$73.65	$131.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.34 / $119.63 / $161.88	Professional	TC	$64.34	$119.63	$161.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.77 / $144.77 / $144.77	Professional		$144.77	$144.77	$144.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.48 / $127.22 / $166.71	Professional	26	$90.48	$127.22	$166.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.08 / $354.66 / $498.81	Professional	TC	$231.08	$354.66	$498.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.64 / $58.64 / $58.64	Facility	26	$58.64	$58.64	$58.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.65 / $347.25 / $610.76	Professional		$179.65	$347.25	$610.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.00 / $85.49 / $153.96	Professional	26	$53.00	$85.49	$153.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.09 / $242.79 / $489.13	Professional	TC	$111.09	$242.79	$489.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $112.00 / $170.10	Facility	26	$83.78	$112.00	$170.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $161.00 / $226.00	Professional		$65.00	$161.00	$226.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.78 / $83.78 / $188.86	Professional	26	$83.78	$83.78	$188.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $113.55 / $220.38	Professional		$59.52	$113.55	$220.38
United Facility/Professional Professional Modifier Low / Median / High Price $152.06 / $276.68 / $447.89	Professional		$152.06	$276.68	$447.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.77 / $77.13 / $152.46	Professional	26	$53.77	$77.13	$152.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.25 / $189.44 / $286.06	Professional	TC	$94.25	$189.44	$286.06
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $371.04 / $466.96 / $466.96	Facility	26	$371.04	$466.96	$466.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,657.60 / $1,657.60 / $1,657.60	Professional		$1,657.60	$1,657.60	$1,657.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $394.61 / $394.61 / $409.43	Professional	26	$394.61	$394.61	$409.43
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,384.00 / $1,384.00 / $1,384.00	Professional	TC	$1,384.00	$1,384.00	$1,384.00