Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.04 / $67.33 / $99.26	Facility	26	$55.04	$67.33	$99.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.72 / $275.00 / $956.76	Professional		$163.72	$275.00	$956.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.62 / $62.68 / $217.21	Professional	26	$51.62	$62.68	$217.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.71 / $198.26 / $472.65	Professional	TC	$107.71	$198.26	$472.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.32 / $160.60 / $210.49	Professional		$126.32	$160.60	$210.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.18 / $83.59 / $141.19	Professional	26	$41.18	$83.59	$141.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.05 / $104.85 / $209.71	Professional	TC	$80.05	$104.85	$209.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.97 / $153.97 / $153.97	Professional		$153.97	$153.97	$153.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.74 / $144.08 / $178.25	Professional	26	$96.74	$144.08	$178.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $306.35 / $417.28 / $713.27	Professional	TC	$306.35	$417.28	$713.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.24 / $63.24 / $63.24	Facility	26	$63.24	$63.24	$63.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.99 / $421.74 / $728.37	Professional		$220.99	$421.74	$728.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $94.13 / $166.87	Professional	26	$56.69	$94.13	$166.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.88 / $302.57 / $599.03	Professional	TC	$148.88	$302.57	$599.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $89.49 / $127.31 / $208.00	Facility	26	$89.49	$127.31	$208.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $208.00 / $287.00	Professional		$79.00	$208.00	$287.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $89.49 / $89.49 / $202.58	Professional	26	$89.49	$89.49	$202.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.11 / $155.88 / $275.27	Professional		$66.11	$155.88	$275.27
United Facility/Professional Professional Modifier Low / Median / High Price $189.25 / $328.38 / $553.04	Professional		$189.25	$328.38	$553.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.92 / $82.30 / $165.71	Professional	26	$59.92	$82.30	$165.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.93 / $240.55 / $412.67	Professional	TC	$125.93	$240.55	$412.67
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $400.16 / $504.00 / $504.00	Facility	26	$400.16	$504.00	$504.00
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,947.01 / $1,947.01 / $1,947.01	Professional		$1,947.01	$1,947.01	$1,947.01
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $450.76 / $450.76 / $450.76	Professional	26	$450.76	$450.76	$450.76
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,624.23 / $1,624.23 / $1,624.23	Professional	TC	$1,624.23	$1,624.23	$1,624.23