Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $89.13 / $204.17	Facility	26	$60.26	$89.13	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $870.96	Professional		$194.98	$281.84	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $91.20 / $218.78	Professional	26	$54.95	$91.20	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $218.78 / $537.03	Professional	TC	$138.04	$218.78	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $177.83	Professional		$147.91	$173.78	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $54.95 / $97.72	Professional	26	$43.65	$54.95	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $114.82 / $204.17	Professional	TC	$102.33	$114.82	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $154.88 / $199.53	Professional	26	$107.15	$154.88	$199.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $489.78 / $851.14	Professional	TC	$354.81	$489.78	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $95.50	Facility	26	$14.45	$67.61	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $776.25	Professional		$234.42	$478.63	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $97.72 / $177.83	Professional	26	$54.95	$97.72	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $354.81 / $645.65	Professional	TC	$165.96	$354.81	$645.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $186.21 / $389.05	Professional		$60.26	$186.21	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $380.19 / $630.96	Professional		$223.87	$380.19	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $81.28 / $158.49	Professional	26	$63.10	$81.28	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $288.40 / $467.74	Professional	TC	$154.88	$288.40	$467.74
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Professional		$2,398.83	$2,398.83	$2,398.83
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	26	$537.03	$537.03	$537.03
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Professional	TC	$2,041.74	$2,041.74	$2,041.74