Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $162.18 / $426.58	Facility	26	$107.15	$162.18	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $602.56 / $2,754.23	Professional		$398.11	$602.56	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $371.54	Professional	26	$107.15	$181.97	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $426.58 / $1,230.27	Professional	TC	$281.84	$426.58	$1,230.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $1,148.15	Professional		$870.96	$870.96	$1,148.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $199.53 / $223.87	Professional	26	$81.28	$199.53	$223.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $588.84 / $588.84	Professional	TC	$588.84	$588.84	$588.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $257.04 / $331.13	Professional	26	$154.88	$257.04	$331.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $1,071.52 / $1,445.44	Professional	TC	$794.33	$1,071.52	$1,445.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,071.52 / $1,819.70	Professional		$562.34	$1,071.52	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $162.18 / $302.00	Professional	26	$95.50	$162.18	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $891.25 / $1,584.89	Professional	TC	$436.52	$891.25	$1,584.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	26	$199.53	$199.53	$199.53
Medcost Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $831.76 / $2,187.76	Professional		$512.86	$831.76	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $851.14 / $1,479.11	Professional		$524.81	$851.14	$1,479.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $134.90 / $275.42	Professional	26	$102.33	$134.90	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $691.83 / $1,202.26	Professional	TC	$416.87	$691.83	$1,202.26
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	26	$977.24	$977.24	$977.24
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $933.25 / $933.25 / $933.25	Professional	26	$933.25	$933.25	$933.25
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Professional	TC	$5,623.41	$5,623.41	$5,623.41