Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.57 / $63.06 / $85.34	Facility	26	$47.57	$63.06	$85.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.68 / $220.81 / $682.00	Professional		$131.68	$220.81	$682.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $54.04 / $168.86	Professional	26	$43.99	$54.04	$168.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.10 / $148.06 / $280.51	Professional	TC	$84.10	$148.06	$280.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.25 / $327.52 / $327.52	Professional		$98.25	$327.52	$327.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $72.58 / $159.44	Professional	26	$35.19	$72.58	$159.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $164.13 / $164.13 / $164.13	Professional	TC	$164.13	$164.13	$164.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.77 / $144.77 / $144.77	Professional		$144.77	$144.77	$144.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.76 / $126.34 / $155.16	Professional	26	$89.76	$126.34	$155.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.08 / $377.41 / $498.81	Professional	TC	$231.08	$377.41	$498.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.38 / $344.23 / $611.54	Professional		$181.38	$344.23	$611.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.37 / $85.49 / $142.34	Professional	26	$52.37	$85.49	$142.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.76 / $245.53 / $490.58	Professional	TC	$117.76	$245.53	$490.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $112.00 / $157.50	Facility	26	$83.78	$112.00	$157.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $163.00 / $231.00	Professional		$68.00	$163.00	$231.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $83.78 / $83.78 / $112.00	Professional	26	$83.78	$83.78	$112.00
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $309.49 / $309.49 / $309.49	Professional	TC	$309.49	$309.49	$309.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $116.86 / $217.13	Professional		$58.87	$116.86	$217.13
United Facility/Professional Professional Modifier Low / Median / High Price $149.16 / $274.75 / $488.09	Professional		$149.16	$274.75	$488.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.87 / $69.09 / $138.33	Professional	26	$49.87	$69.09	$138.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.33 / $192.28 / $340.90	Professional	TC	$100.33	$192.28	$340.90
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $341.52 / $430.56 / $430.56	Facility	26	$341.52	$430.56	$430.56
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,657.60 / $1,657.60 / $1,657.60	Professional		$1,657.60	$1,657.60	$1,657.60
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $379.76 / $379.76 / $379.76	Professional	26	$379.76	$379.76	$379.76
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $1,357.90 / $1,357.90 / $1,357.90	Professional	TC	$1,357.90	$1,357.90	$1,357.90