Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.48 / $78.88 / $126.00	Facility	26	$69.48	$78.88	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.44 / $425.00 / $947.02	Professional		$287.44	$425.00	$947.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.48 / $118.59 / $226.91	Professional	26	$69.48	$118.59	$226.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.94 / $335.00 / $637.69	Professional	TC	$217.94	$335.00	$637.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $349.59 / $725.19 / $725.19	Professional		$349.59	$725.19	$725.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $91.95 / $91.95	Professional	26	$52.43	$91.95	$91.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.88 / $180.88 / $180.88	Professional		$180.88	$180.88	$180.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.62 / $164.92 / $210.25	Professional	26	$112.62	$164.92	$210.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $532.03 / $672.20 / $897.70	Professional	TC	$532.03	$672.20	$897.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.14 / $713.97 / $1,234.39	Professional		$450.14	$713.97	$1,234.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.86 / $113.05 / $200.46	Professional	26	$66.86	$113.05	$200.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $360.44 / $596.16 / $1,069.86	Professional	TC	$360.44	$596.16	$1,069.86
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $120.00 / $209.25	Facility	26	$105.26	$120.00	$209.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $426.00 / $518.00	Professional		$92.00	$426.00	$518.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $105.26 / $105.26 / $120.00	Professional	26	$105.26	$105.26	$120.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $802.02 / $802.02 / $802.02	Professional	TC	$802.02	$802.02	$802.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $349.09 / $769.88	Professional		$73.95	$349.09	$769.88
United Facility/Professional Professional Modifier Low / Median / High Price $377.63 / $593.05 / $1,034.31	Professional		$377.63	$593.05	$1,034.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $95.81 / $197.54	Professional	26	$69.84	$95.81	$197.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.30 / $503.08 / $891.92	Professional	TC	$311.30	$503.08	$891.92
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $502.88 / $632.64 / $632.64	Facility	26	$502.88	$632.64	$632.64
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,916.35 / $3,113.67 / $3,113.67	Professional		$2,916.35	$3,113.67	$3,113.67
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $680.25 / $680.25 / $680.25	Professional	26	$680.25	$680.25	$680.25
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,539.44 / $2,677.57 / $2,677.57	Professional	TC	$2,539.44	$2,677.57	$2,677.57