Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.69 / $74.98 / $114.50	Facility	26	$59.69	$74.98	$114.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.28 / $275.00 / $604.12	Professional		$200.28	$275.00	$604.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $62.95 / $171.11	Professional	26	$55.00	$62.95	$171.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.59 / $220.00 / $358.73	Professional	TC	$140.59	$220.00	$358.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.75 / $147.75 / $147.75	Professional		$147.75	$147.75	$147.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.46 / $55.31 / $87.44	Professional	26	$43.46	$55.31	$87.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.95 / $171.95 / $171.95	Professional		$171.95	$171.95	$171.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.44 / $154.76 / $199.80	Professional	26	$108.44	$154.76	$199.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $374.64 / $510.86 / $837.76	Professional	TC	$374.64	$510.86	$837.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.80 / $502.29 / $898.37	Professional		$262.80	$502.29	$898.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.51 / $102.38 / $185.57	Professional	26	$63.51	$102.38	$185.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.17 / $369.60 / $753.40	Professional	TC	$184.17	$369.60	$753.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $99.69 / $114.00 / $202.25	Facility	26	$99.69	$114.00	$202.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $256.00 / $343.00	Professional		$88.00	$256.00	$343.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $99.69 / $99.69 / $219.66	Professional	26	$99.69	$99.69	$219.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $184.20 / $323.08	Professional		$73.80	$184.20	$323.08
United Facility/Professional Professional Modifier Low / Median / High Price $225.88 / $401.92 / $658.81	Professional		$225.88	$401.92	$658.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.34 / $89.17 / $178.52	Professional	26	$66.34	$89.17	$178.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.34 / $297.54 / $483.45	Professional	TC	$161.34	$297.54	$483.45
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $429.60 / $540.48 / $540.48	Facility	26	$429.60	$540.48	$540.48
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,388.60 / $2,388.60 / $2,388.60	Professional		$2,388.60	$2,388.60	$2,388.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $543.21 / $543.21 / $543.21	Professional	26	$543.21	$543.21	$543.21
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,032.36 / $2,032.36 / $2,032.36	Professional	TC	$2,032.36	$2,032.36	$2,032.36