Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.06 / $118.33 / $173.94	Facility	26	$107.06	$118.33	$173.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $475.00 / $1,488.14	Professional		$425.00	$475.00	$1,488.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.06 / $140.00 / $309.79	Professional	26	$107.06	$140.00	$309.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $348.93 / $941.28	Professional	TC	$299.00	$348.93	$941.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $352.94 / $861.00 / $861.00	Professional		$352.94	$861.00	$861.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.13 / $198.00 / $225.36	Professional	26	$80.13	$198.00	$225.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $587.24 / $587.24 / $587.24	Professional	TC	$587.24	$587.24	$587.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.02 / $281.02 / $281.02	Professional		$281.02	$281.02	$281.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.70 / $255.83 / $326.44	Professional	26	$173.70	$255.83	$326.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $796.53 / $1,129.08 / $1,489.91	Professional	TC	$796.53	$1,129.08	$1,489.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Facility	26	$122.33	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $639.84 / $1,175.23 / $2,092.00	Professional		$639.84	$1,175.23	$2,092.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.75 / $170.81 / $309.62	Professional	26	$103.75	$170.81	$309.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $490.76 / $977.53 / $1,822.83	Professional	TC	$490.76	$977.53	$1,822.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $163.40 / $185.00 / $330.05	Facility	26	$163.40	$185.00	$330.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $580.00 / $750.00	Professional		$144.00	$580.00	$750.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $163.40 / $163.40 / $393.98	Professional	26	$163.40	$163.40	$393.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.78 / $487.88 / $1,097.73	Professional		$114.78	$487.88	$1,097.73
United Facility/Professional Professional Modifier Low / Median / High Price $527.88 / $946.18 / $1,550.86	Professional		$527.88	$946.18	$1,550.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.66 / $156.84 / $314.23	Professional	26	$108.66	$156.84	$314.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $416.00 / $783.40 / $1,231.02	Professional	TC	$416.00	$783.40	$1,231.02
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $781.84 / $981.20 / $981.20	Facility	26	$781.84	$981.20	$981.20
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,147.01 / $6,147.01 / $6,147.01	Professional		$6,147.01	$6,147.01	$6,147.01
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $937.83 / $937.83 / $937.83	Professional	26	$937.83	$937.83	$937.83
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $5,562.51 / $5,562.51 / $5,562.51	Professional	TC	$5,562.51	$5,562.51	$5,562.51