Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.32 / $52.85 / $83.00	Facility	26	$51.32	$52.85	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $145.74 / $357.00	Professional		$134.40	$145.74	$357.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $53.37 / $148.49	Professional	26	$46.10	$53.37	$148.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.64 / $106.84 / $220.00	Professional	TC	$87.64	$106.84	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $137.69 / $347.74	Professional		$104.55	$137.69	$347.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $78.69 / $143.07	Professional	26	$38.15	$78.69	$143.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $126.24 / $126.24	Professional	TC	$67.84	$126.24	$126.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.47 / $110.33 / $139.94	Professional	26	$77.47	$110.33	$139.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.36 / $196.98 / $257.17	Professional	TC	$142.36	$196.98	$257.17
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 $154.38 / $248.35 / $404.62	Professional		$154.38	$248.35	$404.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $83.61 / $146.72	Professional	26	$55.28	$83.61	$146.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.97 / $158.29 / $257.89	Professional	TC	$97.97	$158.29	$257.89
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $75.20 / $75.54 / $122.56	Facility	26	$75.20	$75.54	$122.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $180.00 / $511.34	Professional		$66.00	$180.00	$511.34
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $75.54 / $75.54 / $75.54	Professional	26	$75.54	$75.54	$75.54
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $129.02 / $322.52 / $322.52	Professional	TC	$129.02	$322.52	$322.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $119.72 / $230.64	Professional		$50.92	$119.72	$230.64
United Facility/Professional Professional Modifier Low / Median / High Price $147.43 / $204.61 / $410.74	Professional		$147.43	$204.61	$410.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.41 / $71.93 / $142.78	Professional	26	$52.41	$71.93	$142.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.44 / $134.07 / $262.33	Professional	TC	$95.44	$134.07	$262.33
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 $915.52 / $1,167.08 / $1,167.08	Professional		$915.52	$1,167.08	$1,167.08
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $323.73 / $409.43 / $409.43	Professional	26	$323.73	$409.43	$409.43
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $591.79 / $757.65 / $757.65	Professional	TC	$591.79	$757.65	$757.65