Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $95.28 / $160.15	Facility	26	$83.00	$95.28	$160.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.54 / $374.41 / $1,208.19	Professional		$255.54	$374.41	$1,208.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.48 / $92.14 / $296.14	Professional	26	$80.48	$92.14	$296.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.65 / $220.54 / $467.11	Professional	TC	$164.65	$220.54	$467.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.55 / $641.42 / $641.42	Professional		$213.55	$641.42	$641.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $122.69 / $217.80	Professional	26	$64.39	$122.69	$217.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $136.21 / $162.63 / $261.95	Professional	TC	$136.21	$162.63	$261.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.00 / $238.00 / $238.00	Professional		$238.00	$238.00	$238.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.56 / $210.18 / $264.42	Professional	26	$147.56	$210.18	$264.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $459.97 / $627.40 / $859.80	Professional	TC	$459.97	$627.40	$859.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.83 / $647.28 / $1,150.83	Professional		$373.83	$647.28	$1,150.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $141.65 / $253.82	Professional	26	$88.39	$141.65	$253.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.47 / $487.79 / $923.77	Professional	TC	$249.47	$487.79	$923.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $138.81 / $157.00 / $267.36	Facility	26	$138.81	$157.00	$267.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $260.00 / $375.00	Professional		$116.00	$260.00	$375.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $157.00 / $157.00 / $157.00	Professional	26	$157.00	$157.00	$157.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $472.32 / $472.32 / $622.40	Professional	TC	$472.32	$472.32	$622.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.55 / $242.22 / $458.55	Professional		$107.55	$242.22	$458.55
United Facility/Professional Professional Modifier Low / Median / High Price $290.20 / $535.42 / $911.85	Professional		$290.20	$535.42	$911.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.74 / $121.14 / $249.63	Professional	26	$89.74	$121.14	$249.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.58 / $400.65 / $658.95	Professional	TC	$199.58	$400.65	$658.95
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $627.76 / $788.32 / $788.32	Facility	26	$627.76	$788.32	$788.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,278.63 / $3,278.63 / $3,278.63	Professional		$3,278.63	$3,278.63	$3,278.63
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $694.28 / $1,009.00 / $1,009.00	Professional	26	$694.28	$1,009.00	$1,009.00
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,780.57 / $2,780.57 / $2,780.57	Professional	TC	$2,780.57	$2,780.57	$2,780.57